实用临床医药杂志2025，Vol.29Issue(13)：7-12,6.DOI:10.7619/jcmp.20245489
食管空肠功能性端端吻合法与顺蠕动侧侧吻合法在腹腔镜食管癌根治术中的应用比较
Comparison of functional end-to-end esophagojejunostomy and side-to-side esophagojejunostomy with cis-peristalsis in laparoscopic radical resection for esophageal cancer
摘要
Abstract
Objective To compare the effects of functional end-to-end esophagojejunostomy(FETE method)and side-to-side esophagojejunostomy with cis-peristalsis(overlap method)on post-operative rehabilitation,anastomotic leakage,and inflammatory-oxidative stress factors in patients un-dergoing laparoscopic radical resection for esophageal cancer.Methods A total of 115 patients with esophageal cancer were selected as study subjects,and were randomly divided into overlap group(n=57)and FETE group(n=58)using random number table method,and both groups underwent lapa-roscopic radical resection for esophageal cancer.The overlap group received the overlap method,and the FETE group received the FETE method.The surgical-related indicators,postoperative recovery indicators,incidence of anastomotic leakage,inflammatory factors[interleukin-10(IL-10),interleu-kin-6(IL-6),tumor necrosis factor-α(TNF-α)],oxidative stress factors[malondialdehyde(MDA),superoxide dismutase(SOD)],pulmonary function indicators[forced vital capacity(FVC),forced expiratory volume in one second(FEV1),FEV1/FVC],and the scores of the esophageal cancer-specific quality of life questionnaire(QLQ-OES18)were compared between the two groups.Results There was no statistically significant difference in intraoperative blood loss between the two groups(P＞0.05).The FETE group had shorter operative time and intraoperative anastomosis time,and a lar-ger number of lymph node dissection compared with the overlap group,with statistically significant differences(P＜0.05).The FETE group had earlier postoperative first flatus time,first oral intake time,and drainage tube removal time compared with the overlap group,with statistically significant differences(P＜0.05).The incidence of anastomotic leakage was 1.72％in the FETE group and 7.02％in the overlap group,with no statistically significant difference(P＞0.05).One week after surgery,the serum levels of IL-10,IL-6,TNF-α and MDA in the FETE group were lower than those in the overlap group,while the serum SOD level was higher,with statistically significant differences(P＜0.05).One week after surgery,the FVC,FEV,and FEV1/FVC in the FETE group were higher than those in the overlap group,with statistically significant differences(P＜0.05).Three months after surgery,the QLQ-OES18 functional domain scores in the FETE group were higher than those in the overlap group,while the symptom domain and single symptom domain scores were low-er,with statistically significant differences(P＜0.05).Conclusion Both the FETE method and the overlap method can reduce intraoperative blood loss and the incidence of anastomotic leakage when applied in laparoscopic radical resection for esophageal cancer.However,FETE method has shorter operative time,larger number of intraoperative lymph node dissections,faster postoperative recovery,and patients have less inflammatory-oxidative stress response and pulmonary function im-pairment,as well as higher quality of life after surgery,showing greater advantages compared with the overlap method.关键词
腹腔镜食管癌根治术/食管空肠功能性端端吻合法/食管空肠顺蠕动侧侧吻合法/吻合口漏/炎症因子/氧化应激因子/肺功能/生活质量Key words
laparoscopic radical resection for esophageal cancer/functional end-to-end esophagojejunostomy/side-to-side esophagojejunostomy with cis-peristalsis/anastomotic leakage/inflammatory factors/oxidative stress factors/pulmonary function/quality of life分类
医药卫生引用本文复制引用
杨锋,姜涛,杨三虎,陈鹏,黄立军,雷鸣,张亮..食管空肠功能性端端吻合法与顺蠕动侧侧吻合法在腹腔镜食管癌根治术中的应用比较[J].实用临床医药杂志,2025,29(13):7-12,6.基金项目
陕西省重点研发计划项目(2022SY-265) （2022SY-265）
