食管癌三野淋巴结清扫术食管胃颈部吻合方式对术后吻合口相关并发症的影响

Effect of esophageal three field lymphadenectomy gastroesophageal anastomotic mechanical cervical anastomosis on anastomotic complications

[目的]探讨食管癌三野淋巴结清扫术食管胃颈部吻合口机械吻合对术后吻合口并发症影响情况。[方法]选取2002年2月-2014年11月我院收治82例食管癌患者随机分为观察组和对照组,2组患者术后颈部分别采用机械吻合和人工吻合,比较2组吻合时间、吻合费用及吻合口瘘和吻合口狭窄发生情况。[结果]观察组吻合时间明显短于对照组[（15.1±4.6）min（29.4±4.3）min,P〈0.05];观察组吻合费用明显高于对照组[（3698.6±356.1）元（325.5±22.8）元,P〈0.05]。观察组吻合口瘘发生率为2.44%,对照组发生率为7.32%,2组比较差异无统计学意义（P〉0.05）。观察组吻合口狭窄发生率为19.51%明显高于对照组2.44%,比较差异有统计学意义（P〈0.05）。[结论]食管癌三野淋巴结清扫术食管胃机械吻合相比人工吻合操作简单、吻合效果显著,但可增加吻合费用,提高吻合口狭窄发生率,临床中应根据具体情况进行吻合方式选择,以获得最佳吻合效果。

[Objective]To investigate the effect of esophageal three field lymphadenectomy gastroesophageal anastomotic mechanical cervical anastomosis on anastomotic complications.[Methods]From February2002 to November 2014,82 cases of esophageal cancer patients in our hospital were randomly divided into observation group and control group.Mechanical anastomosis and artificial anastomosis were applied for postoperative neck respectively.Then anastomosis time,anastomosis cost,anastomotic leakage and anastomotic stricture occurrence of the both groups were compared.[Results]Anastomosis time of the observation group was significantly shorter than the control group[（15.1±4.6）min vs.（29.4±4.3）min,P〈0.05];anastomosis cost of the observation group was obviously higher than the control group[（3698.6±356.1）yuanvs.（325.5±22.8）yuan,P〈0.05].The anastomotic fistula incidence of the observation group was2.44%,in the control group the rate was 7.32%,and the difference between the two groups had no statistical significance（P〈0.05）;incidence of anastomotic stenosis in the observation group was 19.51%,apparently higher than that of the control group 2.44%,and the difference was statistically significant（P〈0.05）.[Conclusion]Compared with artificial anastomosis,esophageal three-field lymphadenectomy gastroesophageal anastomotic mechanical operation was simple and effective,but increased the cost of anastomosis and the incidence of anastomotic stenosis.Doctors should choose suitable method to achieve the best fit effect according to the specific circumstances.