RESUMEN
Objective To analyze the correlation between the tubular gastric width and the anti gastroesophageal reflux after esophageal cancer operation,and to provide reference for the choice of surgical methods in treatment of esophageal cancer.Methods Selected 60 patients who received radical surgery for esophageal carcinoma combined with gastric tube reconstruction surgery in our hospital from January 2015 to October 2015,and divided them into two groups according to the way of stomach tube anastomosis (cervical anastomosis,thoracic anastomosis) and different width of gastric tube (greater than or equal to or less than 3 cm).Namely:cervical anastomosis + greater than or equal to 3 cm group(14 cases),cervical anastomosis + less than 3 cm group(15 cases),thoracic anastomosis + greater than or equal to 3 cm group(15 cases) and thoracic anastomosis + less than 3 cm group(16 cases).All patients recieved esophageal pH monitoring for 3 days continuously from the 11 th day after operation.The monitoring indicators include:number of reflux,accumulation time of pH ＜ 4,whether there were clinical symptoms (heartburn,chest pain,pharyngeal foreign body sensation,cough,asthma,etc.) after surgery,and the frequency and time of these clinical symptoms appeared.All the patients were given endoscopic examination at the 14th days postoperatively.Observed the esophageal mucosa of patients and conducted histopathological grading of gastric mucosal inflammation.And then made a correlation analysis of gastric tube width and esophageal mucosal inflammation grade among all the patients with reflux symptoms.Results The cumulative time and number of reflux,incidence rate of clinical symptoms,and pH values less than 4 were significantly different(P ＜ 0.05).The cumulative time and number of reflux,incidence rate of clinical symptoms,and pH values less than 4 in the cervical anastomosis + less than 3 cm group were significantly lower than that in the other 3 groups(P ＜ 0.05),with statistical significance between different groups of endoscopic esophageal mucosa inflammation grade difference (P ＜ 0.05).Esophageal mucosal inflammation grading in patients of the cervical anastomosis + less than 3 cm group was the lightest.It showed a linear correlation between the gastric tube width and esophageal mucosal inflammation grading in patients with reflux symptoms.Conclusion Postoperative gastroesophageal reflux is closely related to stomach esophagus width after resection of esophageal carcinoma with tubular stomach reconstruction of stomach esophagus,because it is unable to control gastric tube width to the appropriate range.And it should be strengthened in patients with reflux related indicators for monitoring,so as to take measures to prevent gastroesophageal reflux as soon as possible to improve the prognosis of patients with quality.