食管-胃胸顶器械吻合法在食管中上段癌手术中的应用  

Application of gastro-esophageal instrumental anastomosis at the chest top in resection of carcinoma at the upper / middle part of esophagus

作　　者：徐俊 陈旭 汪华 梁青松 罗晖 

机构地区：[1]四川省南充市中心医院心胸外科,四川南充637000

出　　处：《实用医院临床杂志》2014年第6期165-167,共3页Practical Journal of Clinical Medicine

摘　　要：目的探讨食管-胃胸顶器械吻合法在食管中上段癌手术中的应用价值。方法我院行食管癌手术的247例患者,其中108例采用经上腹正中切口联合右胸切口方法(胸顶器械吻合组),139例采用食管-胃颈部手工吻合(颈部吻合组),对比两种吻合方式吻合口瘘发生率及术后三年复发转移情况。结果两组吻合口瘘发生率比较,差异有统计学意义(P<0.05);术后三年无复发转移情况比较,差异无统计学意义(P>0.05)。结论经上腹、右胸行食管癌切除、食管-胃胸顶器械吻合在保证患者术后生存时间的基础上,减少了吻合口瘘的发生,优于传统的食管胃颈部吻合的手术方式。Objective To investigate the application value of gastro-esophageal instrumental anastomosis at the chest top in re- section of carcinoma at the upper/middle part of esophagus. Methods We performed the operations of esophageal carcinoma in 247 cases. Of these patients, 108 were treated with the method of gastro-esophageal anastomosis at the chest top （ thoracic gastro-esophageal anastomosis group）while another 139 were treated with the traditional method of gastro-esophageal anastomosis in neck （neck gastro-e- sophageal anastomosis group）. The incidence of anastomotic fistula and postoperative 3 year survival rate were compared between the two groups. Results There was significant difference in the incidence of anastomosis fistula between the two groups （ P 〈 O. 05 ）. By contrast, no significant difference in the postoperative 3 year survival rate was found between the two groups. Conclusion The method of gastro-esophageal instrumental anastomosis at the chest top has a lower incidence of anastomotic fistula that is better than the tradi- tional method.

关 键 词：食管癌 食管胃吻合方式 生存率 吻合口瘘的发生率 

分 类 号：R655.4[医药卫生—外科学]