手工与吻合器行食管胃吻合术后胃食管反流症状的临床观察

Clinical observation of gastroesophageai reflux symptoms after esophagogastric anastomosis by hand vs stapler

目的通过临床观察应用手工和吻合器行主动脉弓下食管胃吻合术后的胃食管反流症状的发生率和程度，以指导选择一种合理的吻合方法。方法全组30例，分成手工组（17例）和吻合器组（13例），观察从开始进食到进食后1个月胃食管反流的发生率和程度。结果手工组有4例术后出现胃食管反流（23．5％），无严重反流病例；吻合器组11例（84．6％）术后出现胃食管反流，重度反流4例。全组无吻合口瘘、狭窄，无术后死亡。结论食管胃黏膜管套叠吻合比吻合器吻合在术后抗反流上有优势，在进行主动脉弓下食管胃吻合时应尽量选择具有良好抗反流效果的吻合方法。

Objective To choose a good method that can effectively prevent reflux by observing the incidence and the extent of gastroesophageal reflux after esophagogastric anastomosis under aortic arch by hand and stapler. Methods Thirty cases of the whole group were divided into manual group （17 cases） and stapler group （13 cases ）. The incidence and the extent of gastroesophageal reflux symptoms from starting eating to 1 month after eating were observed. Results In manual group,there were 4 cases （ 23.5% ） of gastroesophageal reflux, and no cases of severe reflux. In stapler group, there were 11 cases （ 84.6% ） of gastroesophageal reflux,and 4 eases of severe reflux. There was no fistula,no stenosis, and no postoperative deaths. Conclusion Esophagogastric anastomosis with mueosal and invagination has an advantage in the anti - reflux over stapler anastomosis. It is recommended that we should try to choose a good anastomosis method that can effectively prevent reflux.