吻合器在高龄食管癌和贲门癌手术中的应用  

Application of anastomat in surgery of esophageal cancer or carcinoma of gastric cardia in elderly

作　　者：宋长山 钟碧华[2] 吴祖培 聂广杰 彭士俊[2] 

机构地区：[1]佛山市顺德区中西医结合医院胸外科,广东佛山528333 [2]揭阳市人民医院胸外科,广东揭阳522000

出　　处：《新乡医学院学报》2009年第3期271-273,共3页Journal of Xinxiang Medical University

摘　　要：目的探讨食管胃器械吻合法在高龄食管癌和贲门癌手术中的临床应用。方法76例高龄食管癌（49例）和贲门癌（27例）患者施行食管癌及贲门癌切除消化道重建术,手术中施行消化道器械吻合,术后观察吻合口近期和远期并发症发生情况。结果76例术后发生吻合口瘘1例（1.32%）,吻合口出血2例（2.63%）,均经保守治疗后痊愈。术后病理食管切缘癌残存3例（3.95%）,行放射治疗和保守治疗。随访1-3 a,并发吻合口狭窄4例（5.26%）,胃食管反流发生率为9.21%（7/76）。1 a生存率80.2%（61/76）,3 a生存率55.3%（42/76）。结论高龄食管癌贲门癌手术中,器械吻合安全快捷,但应注意预防吻合口狭窄和吻合口切缘癌残留等重要并发症。Objective To explore the application of mechanical anastomat in surgery of esophageal carcinoma or carcinoma of gastric cardia in elderly. Methods 76 elderly cases with esophageal carcinoma （49 cases） or cardiac carcinoma （27 cases） underwent enteron reconstruction, and enteron mechanical anastomat was used during the surgery. The recent period and long-term complications of anastomotic stoma were observed after operation. Results Among 76 cases, anostomotic leakage happened in one case （ 1.32% ） and anostomotic bleeding occurred in two cases（2.63% ）, but they all well-healed by expectant treatment. There were 3 cases（3.95% ） with relict cancer at the cutting edge of esophago and they were given radiotherapy and expectant treatment. Be followed up for one to three years, benign anastomotic stenosis was found in 4 patients （5.26%）, and the incidence of gastroesophageal reflux was 9.21 （7/76）. The survival rate for one year and three years were 80.2% （61/76） and 55.3% （42/76） reapectively. Conclusion Mechanical anastomsis with a stapler in surgery of esophageal carcinoma or carcinoma of gastric cardia in elderly is safe and convenient, but the important complications including anastomotic stenosis and relict cancer at the cutting edge should be prevented.

关 键 词：食管癌 贲门癌 吻合器 器械吻合 并发症 

分 类 号：R571[医药卫生—消化系统]