Effects of different surgical methods for esophagectomy on esophageal reflux after esophageal cancer surgery

doi:10.3877/cma.j.issn.2095-8773.2015.04.006

Abstract

Abstract:

Objective

To investigate the effects of different surgical methods for esophagectomy on gastroesophageal reflux after esophageal cancer surgery.

Methods

One hundred and twenty-six patients with esophageal cancer undergoing esophagectomy by different surgical methods were divided into video-assisted thoracic surgery(VATS) group (n=46), Ivor-Lewis group (n=38) and Sweet group (n=42). Tubular stomach anastomosis was conducted in VATS group and Ivor-Lewis group, full stomach sewn anastomosis was carried out in Sweet group, and esophageal stomach stapling side anastomosis was performed in three groups. Esophageal 24 h pH monitoring was done after operation. The reflux episode, number of reflux more than 5 min, longest reflux time and total time of pH less than 4.0 were compared among three groups.

Results

There were significant differences in the reflux episode, number of reflux more than 5 min, longest reflux time and total time of pH less than 4.0 among three groups(F=7.853, P<0.05; F=6.428, P<0.05; F=12.785, P<0.05; F=10.425, P<0.05). The degree of reflux: Sweet group> Ivor-Lewis group> VATS group.

Conclusions

Esophageal reflux occurs after digestive tract reconstruction of esophageal cancer surgery, and can be effectively relieved by tubular stomach anastomosis.

Key words: Surgical methods for esophagectomy, Gastroesophageal reflux, Esophageal pH monitoring

Yali Diao, Qingtong Shi, Yang Bao. Effects of different surgical methods for esophagectomy on esophageal reflux after esophageal cancer surgery[J]. Chinese Journal of Thoracic Surgery(Electronic Edition), 2015, 02(04): 237-240.

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References 16

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项目		VATS组(n＝46)	Ivor-Lewis组(n＝38)	Sweet组(n＝42)	统计值	P值
年龄(±s，岁)		58.7±9.3	59.1±9.2	58.3±8.9	t＝－0.067	0.385
性别		?	?	?	χ²＝0.003	0.680
?	男性	29(63.0)	26(68.4)	24(57.1)	?	?
?	女性	17(37.0)	12(31.6)	18(42.9)	?	?
病灶位置		?	?	?	χ²＝0.032	0.523
?	上段	9(19.6)	8(21.1)	8(19.1)	?	?
?	中段	20(43.5)	16(42.1)	19(45.2)	?	?
?	下段	17(36.9))	14(36.8)	15(35.7)	?	?
病理类型		?	?	?	χ²＝0.048	0.732
?	溃疡型	20(43.5)	17(44.7)	19(45.2)	?	?
?	蕈伞型	10(21.7)	8(21.1)	10(23.8)	?	?
?	髓质型	8(17.4)	6(15.8)	7(16.7)	?	?
?	缩窄型	8(17.4)	7(18.4)	6(14.3)	?	?
肿瘤分期		?	?	?	χ²＝0.062	0.805
?	Ⅰ期	10(21.7)	8(21.1)	8(19.0)	?	?
?	Ⅱ期	30(65.2)	25(65.8)	28(67.7)	?	?
?	Ⅲ期	6(13.1)	5(13.1)	6(14.3)	?	?

项目		VATS组(n＝46)	Ivor-Lewis组(n＝38)	Sweet组(n＝42)	统计值	P值
年龄(±s，岁)		58.7±9.3	59.1±9.2	58.3±8.9	t＝－0.067	0.385
性别		?	?	?	χ²＝0.003	0.680
?	男性	29(63.0)	26(68.4)	24(57.1)	?	?
?	女性	17(37.0)	12(31.6)	18(42.9)	?	?
病灶位置		?	?	?	χ²＝0.032	0.523
?	上段	9(19.6)	8(21.1)	8(19.1)	?	?
?	中段	20(43.5)	16(42.1)	19(45.2)	?	?
?	下段	17(36.9))	14(36.8)	15(35.7)	?	?
病理类型		?	?	?	χ²＝0.048	0.732
?	溃疡型	20(43.5)	17(44.7)	19(45.2)	?	?
?	蕈伞型	10(21.7)	8(21.1)	10(23.8)	?	?
?	髓质型	8(17.4)	6(15.8)	7(16.7)	?	?
?	缩窄型	8(17.4)	7(18.4)	6(14.3)	?	?
肿瘤分期		?	?	?	χ²＝0.062	0.805
?	Ⅰ期	10(21.7)	8(21.1)	8(19.0)	?	?
?	Ⅱ期	30(65.2)	25(65.8)	28(67.7)	?	?
?	Ⅲ期	6(13.1)	5(13.1)	6(14.3)	?	?

组别	反流次数	反流时间>5 min次数	最长反流时间(min)	pH值<4.0的总时间(min)
VATS组(n＝46)	10. 15±3. 67	5.65±2.59	38.20±20.93	64.23±28.81
Ivor-Lewis组(n＝38)	14. 05±4. 03	7.25±3.38	68.36±45.50	132.42±72.60
Sweet组(n＝42)	19. 37±7. 28	12.03±7.56	104.55±74. 64	216.76±107.84
F值	7.853	6.428	12.785	10.425
P值	<0.05	<0.05	<0.05	<0.05

组别	反流次数	反流时间>5 min次数	最长反流时间(min)	pH值<4.0的总时间(min)
VATS组(n＝46)	10. 15±3. 67	5.65±2.59	38.20±20.93	64.23±28.81
Ivor-Lewis组(n＝38)	14. 05±4. 03	7.25±3.38	68.36±45.50	132.42±72.60
Sweet组(n＝42)	19. 37±7. 28	12.03±7.56	104.55±74. 64	216.76±107.84
F值	7.853	6.428	12.785	10.425
P值	<0.05	<0.05	<0.05	<0.05

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