预防食管癌手术胸内食管胃吻合口瘘的临床观察  

Clinical observation on prevention of intrathoracic esophagus-stomach anastomotic leakage in esophageal cancer surgery

作　　者：吴中平 陈奇勋[2] 

机构地区：[1]富阳市人民医院肿瘤科,浙江富阳311400 [2]浙江省肿瘤医院,浙江杭州310022

出　　处：《中国现代医学杂志》2013年第36期71-73,共3页China Journal of Modern Medicine

摘　　要：目的预防食管癌手术的胸内食管胃吻合口瘘,为食管癌手术治疗提供有效吻合方法。方法将712例食管癌患者随机分为吻合器组387例和对照组325例。吻合器组采用吻合器进行机械吻合;对照组采用常规手工丝线缝合吻合。观察两组的手术情况和术后并发症情况,并进行统计学分析。结果两组均成功手术切除食管恶性肿瘤。吻合器组平均手术时间(153.7±49.0)min;对照组平均手术时间(189.5±56.1)min。吻合器组的手术时间显著低于对照组(P<0.05)。吻合器组术的首次吻合成功率97.16%。两组术后均未出现死亡病例。对照组术后并发症发生率14.46%(47/325);吻合器组术后并发症发生率9.56%(37/387)。吻合器组的术后并发症发生率显著低于对照组(P<0.05)。对照组术后吻合口瘘发生率2.46%;吻合器组术后吻合口瘘发生率0.78%。吻合器组的吻合口瘘发生率显著低于对照组(P<0.05)。结论采用吻合器机械吻合术治疗食管癌操作简便,可缩短手术时间,减少术后吻合口瘘的发生率。[ Objectives] To prevent intrathoracic esophagus-stomach anastomotic leakage in esophageal cancer surgery; to find an effective anastomosis method for esophageal cancer surgery. [Methods] 712 patients with esophageal cancer were randomly divided into mechanical anastomosis group of 387 cases and control group of 325 patients. Mechanical anastomosis group was treated with mechanical anastomosis; control group was treated with manual anastomosis. The surgical situations and postoperative complications were observed and compared. [ Results ] Esophageal malignancy of both groups were successfully reseeted. The mean operative time of mechanical anastomosis group was （153.7±49.0）min; the mean operative time of control group was（189.5±56.1）min. The operation time of mechanical anastomosis group was significantly lower than that of the control group （P 〈0.05）. The first time anastomat success rate of mechanical anastomosis group was 97.16%. No postoperative deaths occulted in both groups. Incidence of postoperative complication of control group was 14.46% （47/325）; incidence of postoperative complication of mechanical anastomosis group was 9.56% （37/387）. Incidence of postoperative complication of mechanical anastomosis group was significantly lower than that of the control group （P 〈0.05）. The anastomotic leakage rate of control group was 2.46%; anastomotic leakage rate of mechanical anastomosis group was 0.78%. The anastomotic leakage rate of mechanical anastomosis group was significantly lower than that of the control group （P 〈 0.05）. [ Conclusions ] In the treatment of esophageal cancer, the mechanical anastomosis is simple and can shorten the operation time, reduce the incidence of anastomotic leakage rate.

关 键 词：食管癌手术 吻合器 机械吻合 手工吻合 食管胃吻合口瘘 

分 类 号：R735.1[医药卫生—肿瘤]