管状吻合器在胸段食管癌切除胃代食管颈部吻合术中的应用研究  

Application of Tubular Staplers in Cervical Esophagogastric Anastomosis for Resection of the Thoracic Esophageal Carcinoma

作　　者：王旭广[1] 杨鲲鹏[1] 张进[1] 黄壮士[1] 葛晓晴[1] 张典[1] 苏彦河[1] 张灿宇[1] 吉庆春[1] 寿化山[1] 

机构地区：[1]郑州大学第二附属医院胸外科,郑州450014

出　　处：《中国现代手术学杂志》2011年第6期417-420,共4页Chinese Journal of Modern Operative Surgery

摘　　要：目的探讨管状吻合器在胸段食管癌切除胃代食管颈部吻合术中的技术方法,总结其应用经验。方法回顾性总结228例胸段食管癌患者的临床资料,其中77例行胸段食管癌切除食管胃颈部管状吻合器吻合术,151例行手工吻合术。结果术后吻合口瘘、乳糜胸、喉返神经损伤、胸胃排空障碍发生率两组无明显差异(P>0.05),但管状吻合器组手术吻合时间显著缩短(P<0.05),吻合口狭窄发生率明显降低(P<0.05)。结论管状吻合器适用于多数胸段食管癌切除胃代食管颈部吻合术,吻合时间短,创伤小,术后并发症发生率低;但对于颈段食管直径过细、胃长度不足等情况更宜手工吻合。术中切除胃小弯制作管状胃可有效延长胃长度,对成功进行胸段食管癌切除胃代食管颈部管状吻合器吻合有帮助。Objective To explore the techniques of the tubular staplers in cervical esophagogastric anastomosis for resection of the thoracic esophageal carcinoma,and to summarize the application experiences of the tubular staplers.Method The clinical data was retrospectively analyzed in 228 cases of thoracic esophageal carcinoma,including 77 cases underwent tubular stapler esophagogastric anastomosis,and the other 151 cases handwork sutures.Results There was no significant difference between the two groups in the anastomotic fistula rate,chylothorax rate,recurrent laryngeal nerve injury rate and the postoperative chest gastric delayed emptying rate（P0.05）.But in the circular stapler anastomosis group,the operative time was significantly shorter（P0.05）,and the incidence of anastomotic stenosis was significantly lower（P0.05）.Conclusions It is recommended of the circular staplers for the majority of thoracic esophagogastric anastomosis with advantages of short anastomosis time,little trauma,low postoperative complication rate.But for the too small diameter of the cervical esophagus,and too short length of the stomach,it is more appropriate of the manual anastomosis.Surgical resection of lesser curvature for the production of the stomach tube can effectively extend the length of the stomach,and may be helpful in the cervical esophageal tubular stapling.

关 键 词：吻合器 食管肿瘤 吻合术 

分 类 号：R735.1[医药卫生—肿瘤]