颈部器械吻合和手工吻合在食管癌手术中的对比应用

Comparative applications of neck stapling technique and manual anastomosis in esophageal carcinoma surgery

目的评价器械吻合和手工吻合在食管癌术中的优缺点。方法回顾性分析456例食管中上段癌患者的临床资料，食管胃吻合时采用吻合器吻合者为器械组，采用传统丝线全层间断缝合者为手工组。比较两组患者的术中及术后情况。结果器械组吻合时间及总手术时间、留置胸管时间、术后住院时间较手工组缩短（P〈0．05），术后进食较手工吻合组早，术中出血量两组比较差异无统计学意义（P〉0．05）。器械组无吻合口瘘发生，两组术后吻合口瘘、吻合口狭窄、肺部并发症发生率两组比较差异有统计学意义（P〈0．05），两组住院费用比较差异无统计学意义（P〉0．05）。结论器械吻合具有操作简便、安全、缩短吻合时间、降低术后并发症发生率，且不增加住院费用的优势。

Objective To evaluate stapling and manual anastomosis advantages and disadvantages of esophageal carcinoma surgery. Methods We retrospectively analyzed 456 patients with mid-thoracic or upper-thoracic esophageal carcinoma who received esophagogastric anastomosis surgery. Stapling technique anastomosis were the stapling group, traditional silk layer interrupted suture were manual group. Intraoperative and postoperative conditions were compared between the two groups. Results The time of esophagogastrostomy and the total operating time, hospitalization time, duration of postoperative chest drainage, in stapling group were shorter than that of manual group, and postoperative eating time was earlier than that of manual group （P 〈 0. 05 ） , there were no significantly difference in the blood loss during surgery between two groups （P 〉 0.05 ） . There were statistically significant between two groups in postoperative anastomotic leakage, anastomotic stenosis, the incidence of pulmonary complications （P 〈 0. 05 ）. There was no significantly difference in hospitalization costs between two groups （P 〉 0.05 ） . Conclusions Stapling technique is simple, safe, and shorter anastomosis time, reduce the incidence of postoperative complications, and has advantage of hospitalization costs without increasing.