食管癌患者食管-管状胃环形吻合器端侧吻合与半器械侧侧吻合近期治疗效果观察

Observation on short-term effects of end-to-side anastomosis versus side-to-side anastomosis in esophagogastrostomy

目的：观察食管癌患者食管-管状胃环形吻合器端侧吻合与半器械侧侧吻合术后近期治疗效果。方法回顾性分析66例手术治疗食管癌患者的临床资料。30例采用食管-管状胃颈部半器械侧侧吻合术，36例采用食管-管状胃胸内环形吻合器端侧吻合术，比较两种吻合术后近期吻合口瘘、吻合口狭窄、反流性食管炎的发生率。结果半器械侧侧吻合术食管狭窄和反流性食管炎的发生率分别为3.3%（1/30例）和20.0%（6/30例），均低于环形吻合器吻合术的25.0%（9/36例）和61.1%（22/36例），两组比较差异有统计学意义（ P﹤0.05）；半器械侧侧吻合和环形吻合器吻合术后吻合口狭窄发生率分别为3.3%（1/30例）和5.6%（2/36例），两组比较差异无统计学意义（ P﹥0.05）。结论食管-管状胃半器械侧侧吻合与形吻合器端侧吻合比较，术后近期吻合口狭窄及反流性食管炎发生率较低。

Objective To observe the short-term effects of end-to-side anastomosis versus side-to-side anastomosis in esophagogastrostomy. Methods The clinical data of 66 patients who underwent surgical treatment for esophageal cancer were retrospectively analyzed,including 30 patients with cervical side-to-side stapled esophagogastric anastomosis and 36 patients with circular end-to-side stapled intra-thoracic anastomosis. The short-term incidence of anastomotic leakage,stenosis and reflux esophagitis was analyzed between the two surgical treatments. Results Circular end-to-side stapled intra-thoracic anasto-mosis was associated with a stenosis rate of 25. 0%（9/36）and a reflux esophagitis rate of 61. 1%（22/36）. Cervical side-to-side stapled esophagogastric anastomosis was associated with a lower rate of stenosis （3. 3%,1/30）and reflux esophagitis（20. 0%,6/30）. There was no difference in the rate of reflux esoph-agitis between circular end-to-side stapled intra-thoracic anastomosis（5. 6%,2/36）and cervical side-to-side stapled esophagogastric anastomosis（3. 3%,1/30）. Conclusion Compared with the circular end-to-side stapled intra-thoracic esophagogastric anastomosis,cervical side-to-side stapled esophagogastric anas-tomosis has a lower incidence of stenosis and reflux esophagitis.