4-0 VICRYL Plus缝线加强缝合颈部吻合口预防吻合口瘘在食管癌切除术中的应用

Application of VICRYL Plus 4-0 Suture in the Prevention of Anastomotic Leakage in the Prevention of Anastomotic Leakage in Patients with Esophageal Cancer

目的探讨4-0 VICRYL Plus缝线加强缝合颈部吻合口预防吻合口瘘在食管癌切除术中的应用。方法分析2014年1月~2016年4月217例食管癌切除患者临床资料,A组113例在吻合器完成后使用4-0 VICRYL Plus缝线全层间断缝合加强颈部吻合口,针距约3~5 mm。B组104例未采用加强缝合。术后均常规放置胸管、胃管、鼻肠管等,颈部切口(吻合口旁)引流管等。结果确诊为术后吻合口瘘19例,A组3例,B组16例,无死亡病例。术后瘘的患者均保守治疗痊愈或好转。两组住院时间无统计学差异,A组发生吻合口瘘和术后返流的概率低于B组(P=0.001)。结论 4-0 VICRYL Plus缝线加强缝合颈部吻合口预防吻合口瘘在食管癌切除术中能有效降低发生吻合口瘘和术后返流的概率。

Objective To explore the application of VICRYL Plus 4 - 0 suture in the prevention of anastomotic leak- age in the cervical anastomotic stoma to prevent anastomotic leakage. Methods analysis of the January 2014 - 2016 year in April 217 cases of esophageal cancer patients with clinical data of 113 cases in A group after the completion of the use of 4 - 0 VICRYL Plus stapler suture full - thickness interrupted suture to strengthen the neck anastomosis, the needle distance is about 3 -5mm. B group of 104 cases did not use to strengthen the suture. After conventional chest tube, tube and nasal tube, neck incision （ anastomotic side） drainage tube etc. Results 19 cases of anastomotic leakage after oper- ation, 3 cases in A group, 16 cases in group B, and no death case. After the operation, the patients were cured or im- proved by conservative treatment. The two groups no significant difference in hospitalization time, A group had anasto- motic fistula and postoperative regurgitation rate lower than that of group B （P = 0. 001 ）. Conclusions 4 - 0 VICRYL Plus suture suture anastomosis in neck to strengthen the prevention of anastomotic fistula can effectively reduce the proba- bility of occurrence of anastomotic fistula and postoperative regurgitation in resection of esophageal carcinoma.