胃食管颈部器械吻合新方法的疗效分析—胃部洞型切口吻合法

Analyses of Curative Effect with the New Method-Anastomosis of the Esophagus and Stomach in Cervical Part by Anastomotic Device with Hole Incision in Gastric Wall

目的:比较胃部洞形切口胃食管颈部器械吻合新方法和传统丝线手工吻合及常规器械吻合治疗食管癌的疗效。方法:应用胃部洞形切口胃食管颈部器械吻合新方法治疗食管癌25例为研究组,另分别随机抽取同期病例各30例应用传统丝线手工吻合及常规器械吻合治疗食管癌为对照组,行病例对照研究。结果:应用此种新方法行颈部食管胃器械吻合,其吻合口瘘的发生率及伤口感染率均明显低于手工丝线吻合,且有显著性差异(P<0.05)。此新方法治疗食管癌病例多为胸上段食管癌,病变高度明显高于丝线手工吻合及常规器械吻合,有显著性差异(P<0.01),明显节省手术时间,减少术后住院时间,均有显著性差异(P<0.05)。新方法治疗食管癌术后吻合口狭窄及切口阳性率有低于丝线手工吻合及常规器械吻合的趋势,但暂无显著性差异(P>0.05)。结论:胃部洞形切口胃食管颈部器械吻合新方法治疗食管癌与传统丝线手工吻合及常规器械吻合比较,更加适合高位胸上段食管癌,并能明显降低术后吻合口瘘及伤口感染率,显著节省手术时间,缩短术后住院时间,有减少术后吻合口狭窄及切缘阳性率的趋势。

Objective： To compared the curative effect of the new method （anastomosis of the esophagus and stomach in cervical part by anastomotic device with hole incision in gastric wall ）with the tradition anastomosis method by hand and the common anastomosis method by device. Methods： The patients were divided into A, B and C groups：25 patients （group A） were treated with the new method, 30 patients （group B） were treated with the tradition anastomosis method by hand, 30 patients （group C） were treated with the common anastomosis method by device.The curative effect of these groups were compared. Results： The incidence of anastomosis leakage and wound infection in group A was lower than group B. and there was statistically significant difference between the two groups （P〈 0.05）. The patients with upper part of esophageal cancer was more in group A than group B and group C, and there was statistically significant difference between the three groups （P〈0.01）. The operation time and length of stay after operation was shorter in group A than group B.But about the incidence of anastomosis stricture and tumor remnant rate of the resected end, there was no statistically significant difference between the three group （P〉0.05）. Conclusion： Compared with the tradition anastomosis method by hand and the common anastomosis method by device, The new method is more suitalbe for the patients with upper part of esophageal cancer; lower incidence of anastomosis leakage and wound infection; shorter operation time and length of stay after operation.