单层或双层食管胃颈部吻合术治疗食管癌50例

Single-or Double-layer Esophagogastric Anastomosis of the Cervical Esophagogastrostomy for the Treatment of Esophageal Carcinoma(A Report of 50 Cases)

目的比较两种吻合技术行食管胃颈部吻合的临床效果。方法因食管癌行食管次全切除、食管胃颈部吻合术共50例,其中采用双层吻合法34例,单层吻合法16例。结果双层吻合法的吻合口瘘发生率为23.5%(8/34),单层吻合法的吻合口瘘的发生率为6.2%(1/16)。两组病人均无吻合口狭窄。结论总之,单层吻合法较双层吻合法减少了手术步骤,缩短了手术时间,减少了吻合口瘘的发生率,值得在食管癌切除术后颈部食管胃吻合中应用。

Objective To compare the clinical results of two techniques of anastomosis for esophagogastrostomy.Methods Subtotal esophagectomy and cervical esophagogastrostomy were performed in 50 cases from January 1999 to December 2010.Subtotal esophagectomy was accomplished via the left thoracic incision and left cervical incision.And the gastro was drawn through the mediastinum and exteriorized in the cervical incision for the esophagogastrostomy.The hand-sewn anastomosis was performed a double-layer suture（Group A） in 34 cases while single-layer suture in 16 cases（Group B）.Result The incidence of anastomotic leakage was 23.5%（8/34） in the Group A and 6.2 %（1/16） in the Group B.Conclusions The single-layer anastomosis can reduce surgical procedures,shorten the operation time and reduce the incidence of anastomotic leakage.It is worth to be recommended in the cervical esophagogastric anastomosis.