食管癌术后吻合口狭窄预防方法的探讨  

The investigation of methods for prevention of anastomotic stenosis after resection of esophageal cancer

作　　者：温仁祝[1] 陈铭伍[1] 冼磊[1] 戴磊[1] 张亚男[1] 

机构地区：[1]广西医科大学第一附属医院胸外科,广西南宁530021

出　　处：《中国癌症杂志》2016年第6期552-555,共4页China Oncology

摘　　要：背景与目的:食管癌是我国常见的恶性肿瘤之一。吻合口狭窄是食管癌术后常见的并发症之一,严重影响患者术后生活质量。该研究通过吻合技术的改变,探讨预防食管癌术后吻合口狭窄的方法。方法:患者随机分组,单号入院者为对照组,双号入院者为实验组。对照组患者行食管胃吻合时采用吻合器直接行食胃管吻合,实验组患者行食管胃吻合前,先荷包缝合收缩吻合部胃壁再上吻合器行食管胃吻合。术后6个月后随访,统计两组患者吻合口狭窄的发生率并进行统计学比较。结果:对照组患者术后吻合口狭窄发生率为19.2%,实验组患者为0%,差异有统计学意义(χ2=22.8,P<0.005),对照组吻合口狭窄发生率明显高于实验组。结论:食管癌手术用吻合器吻合胃和食管前先荷包缝合收缩吻合部胃壁的方法可有效降低食管癌术后吻合口狭窄的发生。Background and purpose： Esophageal cancer is one of the common malignant tumors in our country. Anastomotic stenosis is a common complication after resection of esophageal cancer, seriously affecting the quality of life of patients after operation. By changing anastomosis, this study explored the methods for prevention of anastomotic stenosis after esophageal cancer surgery. Methods： Patients were randomly divided into groups. Patients admitted on odd dates were placed in the control group whereas patients admitted on even dates were placed in the experimental group. Patients in the control group were treated with gastroesophageal anastomosis using anastomat for gastroesophageal anastomosis. Anastomotic stomach was contracted by purse string suture at first, and then treated with stapler gastroesophageal anastomosis, before the gastroesophageal anastomosis was carried out on patients in the experimental group. After 6 months＇ follow-up, the incidences of anastomotic stenosis between the two groups were compared. Results： The postoperative anastomotic stenosis rate in the control group was 19.2%, while that in the exper- imental group was 0%. There were statistically significant differences between them （χ^2=22.8, P〈0.005）. The incidence of anastomotic stenosis in the control group was significantly higher than that in the experimental group. Conclusion： Anastomotic stomach contracted by purse string suture before stapler gastroesophageal anastomosis can effectively reduce the occurrence of anastomotic stenosis after esophageal cancer surgery.

关 键 词：食管癌 食管胃吻合 吻合口狭窄 

分 类 号：R735.1[医药卫生—肿瘤]