摘要
Background:Esophagectomy remains the most reliable technique for managing esophageal cancer,but anastomotic complications including postoperative leak,ischemia and stricture negatively affect outcomes of this specific surgery.The aim of this study was to evaluate the effects of a novel method of esophagogastric anastomosis for reducing postoperative dysphagia and stricture formation.Methods:Eighty patients who were scheduled for esophagectomy due to esophageal cancer were randomly assigned into two groups:intervention and control(40 each).In the control group,the esophagogastric anastomosis was performed with a linear gastric incision,whilst in the intervention group a new method of disc-shaped gastric resection for anastomosis was applied.Postoperative outcomes were compared between the two groups.Results:The incidence of postoperative dysphagia and anastomotic stricture was significantly lower in the disc-shaped resection group(dysphagia 45%vs 75%,P=0.02;stricture 12.5%vs 32.5%,P=0.03),whilst the length of stay in an intensive care unit(ICU),anastomotic leakage and other complications were not significantly different between the two groups(all P>0.05).Conclusion:Anastomotic complications can be reduced by improving surgical techniques.The decreased incidence of postoperative dysphagia and anastomotic stricture in our study may be partly due to providing the proper diameter for the site of anastomosis when using the disc-shaped gastric resection method.Hence,this new method can improve the clinical outcomes of patients who undergo esophagectomy with esophagogastric anastomosis.
目的:食管切除术仍然是治疗食管癌最可靠的技术,但其吻合口并症包括漏、缺血和狭窄等会影响该术式的治疗效果。本研究旨在评估一种新的食管胃吻合方法能否减少术后吞咽困难和狭窄形成。方法:80例拟行食管切除术的食管癌患者随机分为研究组与对照组,每组40例。在对照组中,采用线形胃切除进行食管胃吻合;而在研究组中,采用一种新型的盘形胃切除进行吻合。比较两组患者的临床结局。结果:盘形胃切除组术后吞咽困难和吻合口狭窄的发生率较对照组明显降低(吞咽困难45%vs 75%,P=0.02;狭窄12.5%vs 32.5%,P=0.03),而两组患者ICU住院时间、吻合口漏及其他并发症的差异则无统计学意义(均P>0.05)结论:改进外科技术可以减少术后吻合口并发症。本研究中术后吞咽困难和吻合口狭窄的减少可能部分得益于盘形胃切除所提供的大小合适的吻合口。因此,这项新的吻合技术能改善食管切除食管胃吻合患者的临床结局。
