Modified Gastric Tube versus Gastric Tube in Surgery for Mid-and Lower-thoracic Esophageal Cancer: A Comparative Study_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

 LUWen-min , GUOZhan-ling , LIShu-qing , ZHANGMeng , WANGJue , JINYi

Department of Thoracic Surgery, The Harrison International Peace Hospital of Hengshui Hebei Province, Hengshui 053000, P. R. China;

Corresponding?author：

LUWen-min, Email: hsluwenmin@163.com

Keywords：

Mid- and lower-thoracic esophageal cancer; Modified gastric tube; Respiratory function

DOI：

10.7507/1007-4848.20150213

Video：

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Objective To investigate the application value of modified gastric tube in surgery for mid- and lowerthoracic esophageal cancer compared with gastric tube. Methods A total of 221 patients with mid- and lower-thoracic esophageal cancer who underwent esophagectomy between October 2009 and June 2013 in our hospital were recruited in the study. They were randomly divided into a modified gastric tube group (n=108) and a gastric tube group (n=113). There were 67 males and 41 females at age of 63.50±6.75 years (ranged 47-73 years) in the modified gastric tube group, including 62 cases of middle esophageal cancer and 46 cases of lower esophageal cancer. There were 69 males and 44 females at age of 63.38±7.21 years (ranged 49 to 76 years) in the gastric tube group, including 68 cases of middle esophageal cancer and 45 cases of lower esophageal cancer. The results of surgery and morbidities were recorded. The respiratory functions were recorded at 3 days before surgery, 1 week and 4 weeks after surgery, respectively. Results All surgeries were successfully performed in two groups. There was 1 case of death and 1 case of anastomotic leakage in the gastric tube group. There was no death or anastomotic leakage occurred in the modified gastric tube group. There was statistical difference in the operation time between the modified gastric tube group and the gastric tube group (150.65±11.88 min vs. 174.58±11.99 min, P<0.05). There were no statistical differences in the amount of bleeding during operation or the length of hospital stay between two groups (P>0.05). There were no statistical differences in respiratory function between two groups at 1 week or 4 weeks after surgery (P>0.05). Conclusion For patients with mid- and lower-thoracic esophageal cancer, modified gastric tube has a good clinical application value compared with gastric tube. It is easy and safe, and can decrease the operation time without aggravation of pulmonary function after operation. It is a better esophagus reconstruction method in esophagectomy for mid- and lower-thoracic esophageal cancer in primary hospitals.

Citation： LUWen-min, GUOZhan-ling, LIShu-qing, ZHANGMeng, WANGJue, JINYi. Modified Gastric Tube versus Gastric Tube in Surgery for Mid-and Lower-thoracic Esophageal Cancer: A Comparative Study. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2015, 22(9): 855-858. doi: 10.7507/1007-4848.20150213 Copy

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3.	廖澤飛, 馬良赟, 林勇龍, 等. 管狀胃代食管與傳統食管癌手術后肺部并發癥的對比研究. 臨床肺科雜志, 2013, 18(2):201-202.
4.	李輝. 管狀胃技術在食管重建中的應用. 中國胸心血管外科臨床雜志, 2010, 17(2):89-91.
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8.	武新慧, 張玉想, 胡振杰, 等. 食管癌術后嚴重并發癥臨床分析及對策. 河北醫科大學學報, 2008, 29(5):668-671.
9.	陳萬生, 劉艷慧, 南茹, 等. 食管癌術后的呼吸功能. 中華胸心血管外科雜志, 2007, 23(5):317-319.
10.	李林峻, 吳慶琛, 張誠, 等. 食管癌切除不同消化道重建方式術后患者生命質量的對比分析. 中華醫學雜志, 2013, 93(35):2790-2793.
11.	曾玉山, 黎萍. 管狀胃代食管在胸上中段食管癌治療中的應用.廣州醫學院學報, 2011, 39(6):35-37.
12.	伍傳新, 陳樹群, 林昱, 等. 管狀胃經食管床弓上吻合術對食管癌術后肺功能的影響. 中華胃腸外科雜志, 2010, 13(6):450-451.
13.	楊光煜, 何苡, 胡為才, 等. 53例食管癌賁門癌術后吻合口瘺及相關并發癥的處理. 中華胸心血管外科雜志, 2014, 30(1):11-13.
14.	Ong GB, Lam KH, Wong J, et al. Factors influencing morbidity and mortality in esophageal carcinoma. Thorac Cardiovasc Surg, 1978, 76(6):745-754.
15.	馬良赟, 廖澤飛, 王耿杰. 食管癌術后肺部并發癥危險因素的多因素Logistic回歸分析. 中國危重急救醫學, 2011, 23(10):625-628.
16.	艾波, 付向寧, 嚴華, 等. 不同術式上段食管癌切除術對肺功能的影響. 中國胸心血管外科臨床雜志, 2011, 18(5):413-416.

1. 孫玉鄂, 主編. 胸外科手術學. 第2版. 人民軍醫出版社, 2004. 402.
2. Kocabas A, Kara K, Ozgur G, et al. Value of preoperative spirometry to predict postoperative pulmonary complications. Respir Med, 1996, 90(1):25-33.
3. 廖澤飛, 馬良赟, 林勇龍, 等. 管狀胃代食管與傳統食管癌手術后肺部并發癥的對比研究. 臨床肺科雜志, 2013, 18(2):201-202.
4. 李輝. 管狀胃技術在食管重建中的應用. 中國胸心血管外科臨床雜志, 2010, 17(2):89-91.
5. Avendano CE, Flume PA, Silvestri GA, et al. Pulmonary complications after esophageetomy. Ann Thorac Surg, 2002, 73(3):922-926.
6. Grotenhuis BA, Wijnhoven BP, Grune F, et al. Preoperative risk assessment and prevention of complications in patients with esophageal cancer. J Surg oncol, 2010, 101(3):270-278.
7. Ikeguchi M, Maeta M, Kaibara N. Respiratory function after esophagectomy for patients with esophageal cancer. Hepatogastroenterology, 2002, 49(47):1284-1286.
8. 武新慧, 張玉想, 胡振杰, 等. 食管癌術后嚴重并發癥臨床分析及對策. 河北醫科大學學報, 2008, 29(5):668-671.
9. 陳萬生, 劉艷慧, 南茹, 等. 食管癌術后的呼吸功能. 中華胸心血管外科雜志, 2007, 23(5):317-319.
10. 李林峻, 吳慶琛, 張誠, 等. 食管癌切除不同消化道重建方式術后患者生命質量的對比分析. 中華醫學雜志, 2013, 93(35):2790-2793.
11. 曾玉山, 黎萍. 管狀胃代食管在胸上中段食管癌治療中的應用.廣州醫學院學報, 2011, 39(6):35-37.
12. 伍傳新, 陳樹群, 林昱, 等. 管狀胃經食管床弓上吻合術對食管癌術后肺功能的影響. 中華胃腸外科雜志, 2010, 13(6):450-451.
13. 楊光煜, 何苡, 胡為才, 等. 53例食管癌賁門癌術后吻合口瘺及相關并發癥的處理. 中華胸心血管外科雜志, 2014, 30(1):11-13.
14. Ong GB, Lam KH, Wong J, et al. Factors influencing morbidity and mortality in esophageal carcinoma. Thorac Cardiovasc Surg, 1978, 76(6):745-754.
15. 馬良赟, 廖澤飛, 王耿杰. 食管癌術后肺部并發癥危險因素的多因素Logistic回歸分析. 中國危重急救醫學, 2011, 23(10):625-628.
16. 艾波, 付向寧, 嚴華, 等. 不同術式上段食管癌切除術對肺功能的影響. 中國胸心血管外科臨床雜志, 2011, 18(5):413-416.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Modified Gastric Tube versus Gastric Tube in Surgery for Mid-and Lower-thoracic Esophageal Cancer: A Comparative Study

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