带蒂大网膜预防食管癌术后胸内吻合口瘘的临床应用

Clinical Application of Pedicled Omentum in Preventing Thoracic Anastomotic Fistula after Resection of Esophageal Carcinoma

目的:探讨带蒂大网膜预防食管癌术后胸内吻合口瘘的疗效。方法:选择2013年5月-2015年5月在本院住院的食管中下段癌患者218例为研究对象。将其随机分为用带蒂大网膜包埋吻合口组(A组,114例)和单纯器械吻合口组(B组,104例)。观察两组患者术后胸内吻合口瘘、吻合口狭窄以及心肺并发症情况。结果:A组患者术后无一例吻合口瘘。B组患者发生吻合口瘘6例,两组比较差异有统计学意义(P<0.05)。而两组术后肺部并发症、心率失常及吻合口狭窄情况比较差异无统计学意义(P>0.05)。结论:用大网膜包埋吻合口是降低食管癌术后胸内吻合口瘘的有效术式,且不会对心肺功能造成额外的损害,值得推广。

Objective：To discuss the curative effect of pedicled omentum in preventing fistula of postoperative thoracic anastomosis.Method：Two hundred and eighteen cases of patients with midpiece or lower esophageal carcinoma in our hospital from May 2013 to May 2015 were selected as the objects and randomly divided into two groups.One group was the pedicled omentum anastomosis group（group A,114 cases）,the other group was the simple instrument anastomosis group（group B,104 cases）.The anastomotic leakage,stenosis and cardiopulmonary complications of the two groups were observed after the operation.Result：There was no anastomotic fistula after operation in group A,while there were 6 cases of anastomotic leakage in group B,the difference between the two groups was statistically significant（P〈0.05）.There was no significant difference between the two groups in postoperative pulmonary complications,heart rate disorders and anastomotic stenosis（P〉0.05）.Conclusion：Embedding anastomosis with epiploon is an more effective way to reduce the anastomotic fistula,and will not cause additional damage on the heart and pulmonary function.It is worthy of promoting.