Esophageal valve forming esophageal and gastric sleeve joint surgery for preventing postoperative anastomotic complications of esophageal cancer / 重庆医学

ABSTRACT

Objective To clarify the effect of esophageal valve forming esophageal and gastric sleeve joint surgery for preven‐ting postoperative anastomotic complications of esophageal cancer .Methods A randomized controlled trial was designed to incorpo‐rate a total of 394 patients with esophageal cancer from January 2010 to June 2013 .This study has been registered in the Chinese clinical trial center and received a registration numberChiCTR‐TRC‐13003817 .Among them ,9 cases (2 .3% ) were excluded be‐cause of the non line esophageal cancer radical operation .The remaining patients were randomly divided into two groups ,191 cases in group A and 194 cases in group B ,according to the principle of random grouping .Group A was experimental group ,patients ac‐cepted esophageal valve forming esophageal and gastric sleeve joint surgery ,and group B was the control group ,patients received conventional anastomosis .Results The incidence of anastomotic leakage after operation in group A and group B were 4 .1% and 3 .6% ,thse results were not statistically significant (P=0 .768) .In the observation of anastomotic stenosis ,7 patients died after sur‐gery .In the remaining cases ,there were 13 cases (6 .9% ) and 25 cases (13 .2% ) in group A and group B ,respectively ,the differ‐ence was statistically significant (P=0 .044) .Furthermore ,reflux oesophagitis and Barrett′s epithelium were found in 105 patients (55 .3% ) in group B ,and 54 (28 .7% ) patients in group A ,the difference was statistically significant (P<0 .01) .Conclusion E‐sophageal valve forming esophageal and gastric sleeve joint surgery can effectively prevent postoperative gastroesophageal reflux , but also can reduce the postoperative incidence of anastomotic stenosis .