食管癌颈部机械吻合与手工吻合效果比较

A comparative study of mechanical and manual esophago-gastrostomy for esophageal cancer

目的:比较机械与手工吻合在中上段食管癌颈部吻合术中的疗效。方法:265例中上段食管癌,依吻合方法分为2组,105例手工吻合(组1),160例机械吻合(组2);胃食管吻合175例,食管结肠吻合90例;比较2组吻合时间、吻合口瘘、吻合口狭窄、颈部切口感染、医疗费用、吻合口肿瘤复发率。结果:2组颈部吻合均成功。组1术后并发心肌梗死1例、肺内感染5例;组2并发肺栓塞2例、心房颤动3例。2组吻合时间、吻合口瘘、吻合口狭窄、颈部切口感染发生率、医疗费用之间有显著差异(P<0.05)。结论:机械与手工吻合各有利弊,但机械吻合操作时间短,吻合口瘘、吻合口狭窄及颈部感染率低于手工吻合。

Objective：To compare the effects of mechanical and manual esophagogastrostomy in the neck for e- sophageal cancer. Methods ：Total of 265 patients with esophageal cancer were devided into two groups according to the style of anastomosis, group 1 consisted of 105 cases with manual anastomosis, group 2 consisted of 160 cases with mechanical anastomosis. The anastomosis was respectively completed by esophagogastrostomy in 175 and by esophago- colostomy in 90 in the neck. The duration of anastomosis, incidence of cervical anastomotic leakage, anastomotie steno- sis, neck incision infection, medical expenses and cancer recurrence were compared. Results：The anastomosis of all patients was successfully in the two groups. There was one case with myocardial infarction ,5 cases with pulmonary in- fection in group 1 and 2 cases with pulmonary embolism,3 cases with atrial fibrillation in group 2. There was no signif- icant difference between two groups in the anastomosis duration, anastomotic leakage stenosis, neck incision infection as well as medical expenses（ P 〈 0.05 ）. Conclusion：Both of manual and mechanical anastomosis in cervical recon- struction of esophagus is reliable and beneficial for the patients with esophagus cancer. However, the later is more su- perior to the former with a less duration of anastomosis, anastomotie leakage and stenosis, as well as neck incision in- fection.