食管胃颈部器械吻合在食管癌切除术中的应用

Application of circular staplers in cervical esophagogastric anastomosis after esophageal cancer resection

目的 探讨食管癌切除后使用消化道圆型吻合器行食管胃颈部吻合的安全性和可行性。方法回顾性分析2009年8月至2011年4月间河南省人民医院采用一次性圆形吻合器行食管癌切除后食管胃颈部吻合病例的临床资料。结果202例患者中除1例因吻合时部分食管撕裂而需手工缝合修补外，其余均一次吻合成功。无手术死亡病例。术后出现颈部吻合口瘘6例（3．0％），经保守处理后均在短期内愈合；无胸内吻合口瘘或其他吻合器械相关并发症发生；有2例患者在进食后出现较明显的胃食管反流。经10．2个月的中位随访，全组患者均未发现吻合口狭窄。结论食管癌切除后使用吻合器行食管胃颈部吻合安全、可行。

Objective To evaluate safety and feasibility of circular staplers in cervical esophagogastrostomy after esophageal cancer resection. Methods The clinical data of patients with esophageal carcinoma were analyzed retrospectively. These patients underwent esophagectomy and cervical esophagogastrostomy with mechanical staplers from August 2009 to April 2011 in the Henan Provincial People＇s Hospital. Results A total of 202 patients had the anastomosis performed successfully except for one case who had esophageal tear during anastomosis and required hand-sewn repair. There was no operative mortality. Six patients developed cervical anastomotic leakage after operation, and all were treated conservatively. There was no thoracic anastomotic leakage and other complications related to anastomosis. Two patients had obvious gastroesophageal reflux. After a median of 10.2 months of followup, there was no anastomotic stricture. Conclusion Circular mechanical stapling in cervical esophagogastric anastomosis is a safe and feasible operative procedure.