食管癌切除行弓上食管胃机械吻合术150例  

Use of disposable pipe type stapling aortic arch anastomosis of esophagus and stomach on 150 cases of middle and lower esophageal cancer

作　　者：贾伟[1] 于文江[1] 岳志[1] 常王玉 

机构地区：[1]安徽省阜阳市第五人民医院胸外科,安徽阜阳236000

出　　处：《安徽医药》2012年第4期490-491,共2页Anhui Medical and Pharmaceutical Journal

摘　　要：目的探讨一次性弯管型吻合器行主动脉弓上食管胃吻合术的临床经验。方法回顾性分析150例采用一次性弯管型吻合器行弓上食管胃机械吻合根治性切除术中、下段食管癌。结果一次吻合成功149例,1例失败改为弓旁手工吻合。全组患者1例吻合口出血。术后随访144例,死亡3例,死亡原因:吻合口瘘、严重感染1例,食管主动脉瘘2例。,乳糜胸1例,经对症处理治愈;其余患者术后恢复良好。远期出现吻合口狭窄5例,均经球囊扩张器扩张7次后缓解或治愈。6例失访。结论中、下段食管癌采用左胸后外侧肋间切口,使用弯管型吻合器行食管胃弓上吻合,手术难度虽较大,但术后胃肠道重建并发症较少,患者的生活质量得到提高。Objective To summarize the clinical experience of using of disposable pipe type stapling aortic arch anastomosis of esophagus and stomach.Methods Retrospective analysis was made of 150 cases of middle and lower esophageal cancer resection,with disposable pipe type of stapling bow mechanical esophagogastric anastomosis.Results A hundred and forty-nine cases achieved successful,however,1 patient failed.There was one case of anastomotic bleeding.Postoperative follow-up was performed on 144 cases,3 deaths,the causes of which were anastomotic fistula,a serious infection in 1,and aortic esophageal fistula in 2 cases.There was chylothorax in 1 case,cured by symptomatic treatment.The other patients recovered well.Long-term anastomotic stricture appeared in 5 cases,all expanded by balloon dilator to ease or cure after 7 times.6 cases lost.Conclusion The use of lower esophageal intercostal posterolateral left chest incision and pipe-type esophagus and stomach stapling arch anastomosis performs with surgical difficulty,but there are fewer complications and improved quality of life of patients after the stomach intestine reconstruction.

关 键 词：食管癌 弓上吻合 食管胃机械吻合术 

分 类 号：R735.1[医药卫生—肿瘤]