不同平面吻合加盖大网膜或下肺韧带预防食管、胃吻合口瘘及狭窄  

An Experience in Prevention of Gastro esophageal Anastomotic Leakage and Stricture with Layered Anastomosis at Different Level and the Pedicled Omentum or Pulmonary Ligament Coverage

作　　者：王建华[1] 赵文太[1] 彭玉兴[1] 刘安民[1] 白亚青 刘聚良[1] 孔祥顺[1] 徐秋生[1] 崔恒[1] 

机构地区：[1]河北省邢台市人民医院胸外科

出　　处：《中国胸心血管外科临床杂志》1997年第3期149-150,共2页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

摘　　要：目的改进食管胃吻合方式，降低吻合口瘘及狭窄的发生率。方法将５５２例食管、贲门癌患者随机分为３组，分别采用荷包式吻合；食管胃分层吻合；食管胃不同平面吻合，吻合口加盖大网膜或下肺韧带三种不同的吻合方式，比较各组吻合口瘘及狭窄的发生率。结果吻合口瘘发生率分别为：３．７５％，１．０９％和０；狭窄的发生率分别为：８．１％，３．２５％和０．９６％。三组结果有显著性差异。结论食管胃不同平面吻合，吻合口加盖大网膜或下肺韧带可有效预防食管胃吻合口瘘及狭窄的发生。Objective In order to reduce the incidence of anastomotic leakage and stricture to improve the technic of esophagogastric anastomosis is very important.Methods 552 patients with esophageal and cardiac cancer were randomized into three groups, Group A, whole thickness gastro esophageal anasro mosis as the conventional technic, Group B, layer by layer suturing, Group C, layered suturing of the gastric, esophageal mucosa and muscles at diffe rent level and eoverage with pedicled omentum or pulmonary ligment.Results The incidence of anastomotic leakage in 3 groups were 3.75%, 1.09%, zero and the incidence of anastomotic stricture were 8.1%, 3.25%, 0.96% respectively. Statistical significance among these three groups was evident.Conclusion The layered esophagogastrostomy at different level and covering the pedicled omentum or pulmonary ligament method is the preferable technic to adopt in order to reduce anastomotic leakage and stricture.

关 键 词：食管胃吻合 吻合口瘘 吻合口狭窄 

分 类 号：R655.405[医药卫生—外科学] R656.61[医药卫生—临床医学]