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目的为了解食管癌、贲门癌切除术后胃食管在颈部、弓上和弓下吻合术后发生胃食管反流的差异。方法对１０例正常人和３０例在３个不同平面作胃食管吻合的患者术后１～３月进行残留食管腔内连续２４小时ｐＨ监测。结果（１）食管癌、贲门癌患者术后无论吻合平面位于何处，术后近期内２４小时食管腔内ｐＨ各项监测指标均高于正常（Ｐ＜０．０１）；（２）２４小时总反流次数在３个不同吻合平面吻合术间无差异（Ｐ＞０．０５）；（３）其余监测指标颈部吻合＞弓上吻合＞弓下吻合（Ｐ＜０．０１）。结论食管癌、贲门癌患者术后普遍存在胃食管反流现象。吻合平面越高，反流越严重。降低吻合平面，缩小胸胃体积有利于减少术后反流，提高生活质量。
Objective To understand the difference of gastroesophageal reflux after gastroesophageal esophageal, arch, and arch anastomosis after esophageal or cardiac cancer resection. Methods Forty patients with normal and 30 patients with gastroesophageal anastomosis in three different planes were subjected to continuous 24-hour pH monitoring of residual esophageal cavity from January to March. Results (1) No matter where the anastomosis plane was located after operation in esophageal or cardiac cancer patients, the monitoring index of esophageal lumen pH within 24 hours after operation was higher than normal (P<0.01); (2)24 The total number of hours of reflux was not different between the three anastomosis planes (P>0.05); (3) The other monitoring indexes were neck anastomosis> anastomosis> anastomosis (P<0.01). Conclusion Gastroesophageal reflux is common after surgery in patients with esophageal and cardiac cancers. The higher the anastomosis level, the more severe the reflux. Lowering the anastomotic plane and reducing the volume of the thoracic stomach can help reduce postoperative reflux and improve quality of life.