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有人认为食管癌切除后保留食管末端(包括食管下括约肌)、食管端端吻合并行胃底折叠术可防止术后的胃食管返流。作者对行此术式的14例胸中段食管癌患者进行了术前术后食管压力测定。术前食管下括约肌压力在正常范围,为2.57±0.21kPa,与正常人对照组2.51±0.48kPa无明显差别(P>0.05)。术后患者食管下括约肌压力下降到1.66±0.40kPa,与术前值有明显差别(P<0.05)。手术后胸腔胃压力为1.09±0.44kPa,残余食管压力为1.02±0.36kPa,相差无几,说明食管与胃之间存在一共通腔。可以认为,保留的食管下括约肌已不再能起抗返流屏障的作用。
Some people believe that the retention of esophageal cancer after the end of the esophagus (including the lower esophageal sphincter), esophageal end-to-end anastomosis and fundoplication can prevent postoperative gastroesophageal reflux. The authors performed preoperative and postoperative esophageal pressure measurements in 14 patients with thoracic mid-segment esophageal carcinoma who underwent this surgical procedure. The preoperative pressure in the lower esophageal sphincter was within the normal range of 2.57±0.21 kPa, which was not significantly different from the normal control group of 2.51±0.48 kPa (P>0.05). The postoperative esophageal sphincter pressure dropped to 1.66±0.40 kPa, which was significantly different from the preoperative value (P<0.05). The postoperative pressure in the thoracic cavity was 1.09±0.44 kPa, and the residual esophageal pressure was 1.02±0.36 kPa, which was almost the same, indicating that there was a common cavity between the esophagus and the stomach. It can be considered that the preserved lower esophageal sphincter can no longer act as an anti-reflux barrier.