食管癌术后吻合口狭窄的预防  

Prevention of benign anastomotic stricture post-esophagectomy

作　　者：王新[1] 王铮[1] 王志宏[1] 王俊钢[1] 卢万里[1] WANG Xin;WANG Zheng;WANG Zhihong(Department of Thoracic Surgery,Nanyang Central Hospital,Henan Province,Nanyang 473000,China)

机构地区：[1]河南省南阳市中心医院胸外科,473000

出　　处：《临床外科杂志》2021年第8期736-737,共2页Journal of Clinical Surgery

摘　　要：目的总结预防食管癌、贲门癌术后发生吻合口狭窄的措施。方法2013年1月~2018年1月我院胸外科收治的食管癌、贲门癌病人315例,均采用手术治疗。实验组146例,术前口服庆大霉素生理盐水,术中行胃壁荷包缝合后再进行吻合、减轻吻合口张力,术后及早进食固体食物和口服抑酸药物;对照组169例,仅直接采用吻合器吻合。术后随访2年,比较两组吻合口狭窄发生率。结果对照组术后吻合口狭窄发生率为11.0%,实验组为3.8%,两组比较差异有统计学意义(P<0.05)。结论术前口服庆大霉素盐水,术中行胃壁荷包缝合后再进行吻合、减轻吻合口张力等措施可预防吻合口狭窄。Objective To explore the corresponding measures to prevent anastomotic stenosis after esophagectomy for esophageal and cardiac cancers.Methods Retrospective analysis was made on the clinical data of 315 patients with esophageal and cardia cancers with oesophagectomy performed in the department of Thoracic Surgery of the Nanyang central hospital from January 2013 to January 2018.In the experimental group(146 cases),oral gentamicin saline was taken before operation,anastomosis was performed after intraoperative gastric wall pouch suture,and anastomotic tension was reduced.Solid food and oral acid-inhibiting drugs were taken as early as possible after operation.The control group(169 cases)only adopted stapler anastomosis directly.Postoperative follow-up has been conducted for two years,and the incidence of anastomotic stenosis in the two groups was compared.Results The incidence of anastomotic stenosis in the control group was 11.0%,while the incidence of anastomotic stenosis in the experimental group was 3.8%.The difference was statistically significant(P<0.05).Conclusion Preoperative oral administration of gentamicin saline,intraoperative purse-string suture of the stomach wall before anastomosis,and reduction of anastomotic tension can actively prevent anastomotic stenosis.

关 键 词：食管癌 吻合口狭窄 荷包缝合 预防 

分 类 号：R735.1[医药卫生—肿瘤]