圆形端侧吻合术与T型侧侧吻合术在胸腹腔镜联合食管癌根治术中的对比研究  

Comparative Study of Circular End-to-side Anastomosis and T-shaped Side-to-side Anastomosis in Thoracoscopic and Laparoscopic Combined with Esophageal Cancer Radical Surgery

作　　者：施海展 SHI Haizhan(Putian First Hospital,Putian 351200,China)

机构地区：[1]莆田市第一医院,福建莆田351200

出　　处：《中外医学研究》2024年第35期173-176,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探讨圆形端侧吻合术与T型侧侧吻合术在胸腹腔镜联合食管癌根治术中的效果。方法:回顾性分析2018年6月—2023年6月于莆田市第一医院胸外科治疗的104例食管癌患者的临床资料,根据颈部吻合方式将患者分为T型侧侧吻合组(n=54)和圆形端侧吻合组(n=50),两组均行胸腹腔镜联合食管癌根治术,比较两组术中情况、吻合口并发症及肺部相关并发症。结果:T型侧侧吻合组吻合时间、术中失血量优于圆形端侧吻合组,差异有统计学意义(P<0.05)。两组吻合口瘘、食管胃反流发生率比较,差异无统计学意义(P>0.05);T型侧侧吻合组吻合口狭窄发生率低于圆形端侧吻合组,差异有统计学意义(P<0.05)。T型侧侧吻合组肺不张、肺部感染、胸腔积液发生率低于圆形端侧吻合组,差异有统计学意义(P<0.05)。结论:T型侧侧吻合技术较圆形端侧吻合,在胸腹腔镜联合食管癌根治术中可有效缩短吻合时间,减少术中失血量,降低吻合口狭窄发生率和肺部相关并发症发生率。Objective:To explore the effect of circular end-to-side anastomosis and T-shaped side-to-side anastomosis in thoracoscopic and laparoscopic combined with esophageal cancer radical surgery.Method:The clinical data of 104 patients with esophageal cancer who treated in the Department of Thoracic Surgery of Putian First Hospital from June 2018 to June 2023 were retrospectively analyzed,the patients were divided into the T-shaped side-to-side anastomosis group(n=54)and the circular end-to-side anastomosis group(n=50)according to the cervical anastomosis method,two groups were underwent thoracoscopic and laparoscopic combined with esophageal cancer radical surgery.The intraoperative conditions,anastomotic complications and lung-related complications were compared between two groups.Result:The anastomosis time and intraoperative blood loss in the T-shaped side-to-side anastomosis group were better than those in the circular end-to-side anastomosis group,and the differences were statistically significant(P<0.05).There were no significant differences in the incidence of anastomotic leakage and gastroesophageal reflux between two groups(P>0.05);the incidence of anastomotic stenosis in the T-shaped side-to-side anastomosis group was lower than that in the circular end-to-side anastomosis group,and the difference was statistically significant(P<0.05).The incidence of atelectasis,pulmonary infection and pleural effusion in the T-shaped side-to-side anastomosis group were lower than those in the circular end-to-side anastomosis group,and the differences were statistically significant(P<0.05).Conclusion:Compared with traditional circular end-to-side anastomosis,T-shaped side-to-side anastomosis can effectively shorten the anastomosis time,reduce intraoperative blood loss,and reduce the incidence of anastomotic stenosis and lung-related complications in thoracoscopic and laparoscopic combined with esophageal cancer radical surgery.

关 键 词：胸腹腔镜手术 食管癌根治术 T型侧侧吻合 圆形端侧吻合 

分 类 号：R73[医药卫生—肿瘤]