食管癌切除颈部单层吻合术与传统吻合术疗效对比

A Comparative Study of Esophagogastric Anastomosis by Gambee Method and by Traditional Method after Esophagetomy for Esophageal Carcinoma

目的比较食管癌切除颈部单层吻合术与传统吻合术后并发症和生活质量的差别。方法总结1996年6月-2005年6月间,本院对食管癌行食管部分切除患者,其中食管胃颈部单层吻合术801例,传统吻合术360例。经左胸入路颈部吻合手术1138例,经右胸入路颈部吻合手术23例。结果两组术后颈部吻合口瘘、吻合口狭窄发生率比较,单层吻合组均较低(P<0.05);两组术后生活质量尚满意,胃食管反流比较,单层吻合组比传统吻合组稍高,但差异无统计学意义(P>0.05)。结论选择胃经食管床颈部单层吻合术基本可避免吻合口狭窄,并且可明显提高吻合口的通畅度,从而改善术后病人的生活质量。

Objective To compare the by Gambee method with the traditionanl way in cervical anastomosis after esophagetomy for esophageal carcinoma. Methods 801 patients were constructed the cervical esophagogastric anastomosis by Gambee method after esophagetomy for esophageal carcinoma. And another 360 patients by traditional method. 1138 patients in all them were operated by left thoracic approach, another 23 patients by right thoracic approach. Results The anastomotic leak and stricture, and quality of life were compared for patients by Gambee method and by traditional method. The incidence of anastomotic leak and stricture in the gambee group was significantly less in comparison with the control group （ P 〈 0. 05 ）. All of the patients gained the good quality of life. The incidence of gastroesophageal reflux was similar among the two groups （P 〉 0.05）. Conclusions The cervical anastomsose by gambee method after esophagetomy for esophageal carcinoma resulted in significantly lower anastomotic complications. It can improve the quality of life of patients.