食管癌手术手工吻合与管状吻合器吻合的疗效比较

Comparison of therapeutic efficacy of anastomosis between by hand and by anastomat in esophageal cancer resection

目的 对食管癌手术采用手工吻合与管状吻合器吻合（加强／不加强）重建消化道方法的近远期并发症进行比较。方法 对近年我科接受食管根治术的300例病人的预后进行分析，其中手工吻合、管状吻合器单层吻合不加强、管状吻合器单层吻合浆肌层加强各100例，各组左颈部吻合各20例。结果 手工吻合组术后吻合口瘘6例（颈部4例），吻合口狭窄7例，死亡1例。管状吻合器单层吻合不加强组术后吻合口瘘1例（颈部0例），吻合口狭窄2例，无死亡病例。管状吻合器单层吻合浆肌层加强组术后吻合口瘘2例（颈部1例），吻合口狭窄5例，死亡1例。结论 单层机械吻合不加强操作简便、耗时少、创伤小，并发症少，值得推广。

Objective To compare the long and short term complications of anastomosis between by hand and by anastomat in esophageal cancer resection. Methods Prognosis of 300 cases of esophageal cancer received radical resection was analyzed. Total patients were divided into 3 groups： anastomosis by hand, by anastomat and by anastomat with plasma and muscular reinforcement. Each group has 100 cases, and each group includes 20 cases anastomosis in left cervical part. Results 6 cases of fistula of stoma （4 in cervical part）, 7 cases of stoma constriction and 1 death were encountered in group of anastomosis by hand. One case of fistula of stoma （no in cervical part）, 2 cases of stoma constriction and no death were encountered in group of anastomosis by anastomat only. 2 cases of fistula of stoma （1 in cervical part）, 5 cases of stoma constriction and 1 death were encountered in group of anastomosis by anastomat with plasma and muscular reinforcement. Conclusion Anastomosis by anastomat only is easy to handle, less time needed, minor trauma, few complication and worth to spread.