胸段食管癌三野根治术颈部吻合2种方法效果对比.docVIP

胸段食管癌三野根治术颈部吻合2种方法效果对比 　　作者：柯孙葵，林若柏，段红兵，蔡英杰 作者单位：1.福建医科大学2003级硕士研究生班,福建 厦门;2.福州市协和医院胸外科,福建 福州;3.厦门大学附属中山医院胸外科,福建 厦门 　　【摘要】 目的：对比食管癌三野根治术颈部手工吻合与一次性吻合器吻合的疗效及并发症。方法:收集我院胸外科2002年1月～2008年2月接受食管癌三野根治术的患者217例，颈部吻合分别采取手工吻合和强生一次性吻合器吻合，并将其分为手工吻合组135例，吻合器组82例两组。所有患者术后均观察吻合口瘘、术后6个月吻合口狭窄的发生率。结果：两组患者随访半年，手工吻合组吻合口瘘发生率为9.63%(13/135)，吻合口狭窄发生率为5.19%(7/135)。吻合器组吻合口瘘发生率为2.44%(2/82)，吻合口狭窄发生率为6.10%(5/82)。术后吻合器组吻合口瘘发生率均低于手工吻合组(P0.05);两组患者比较吻合口狭窄发生率差异无统计学意义(P0.05)。结论：在食管癌三野根治术颈部吻合中，吻合器的使用可明显降低吻合口瘘的发生率，不增加吻合口狭窄的发生率，是三野根治术颈部吻合的合理选择。 　　【关键词】 食管肿瘤;吻合口;吻合术，外科 　　Two ways of cervical anastomosis in three field radical esophagectomy for thoracic esophageal carcinoma 　　KE Sunkui1, LIN Ruobai2, DUAN Hongbing3, CAI Yingjie3 　　(1.Master Postgraduate Class in 2003 Grade, Fujian Medical University Xiamen 350004, China;2.Department of Thoracic Surgery, Xiehe Hospital in Fuzhou Fuzhou 350004,China;3.Thoracic Surgery Department, Zhongshan Hospital Affiliated to Xiamen University Xiamen 361004, China.) 　　[ABSTRACT] Objective: To compare the efficacy and complication in the treatment of thoracic esophageal carcinoma with cervical artificial anastomosis in three field radical esophagectomy and with onetime anastomosis. Methods: Collected datas from 217 cases who accepted cervical artificial anastomosis and onetime anastomosis in three field radical esophagectomy from January 2002 to February 2008 in thoracic surgery department of our hospital. Divided all patients into two groups: artificial anastomosis group (135 cases) and stapler anastomosis group (82 cases). Observed the incidence of anastomotic fistula after surgery and anastomotic stricture 6 months later after surgery. Results: The 6month followup showed the incidence of anastomotic fistula were 9.63% and 2.44% respectively in two groups with significant difference (P0.05), while incidence of anastomotic stricture were 5.19% and 6.10% without significant difference (P0.05). Conclusion: Stapler anastomosis can significantl