食管胃套接术与器械吻合术治疗食管、贲门癌的对比研究

The comparative study of the esophagogastrostomy with wrap suturing or stapled anastomoses in treatment of esophageal and cardiac carcinoma

目的 对比食管胃套接术与器械吻合术的临床治疗效果 ,以减少食管、贲门癌根治术后并发症的发生率。 方法 将 2 85例诊断明确的食管、贲门癌住院患者按入院顺序随机分为两组 ,食管胃套接组 (套接组 ) :134例 ,采用食管癌切除食管瓣片成形 -食管胃套接术 ;器械吻合组 (吻合组 ) :15 1例 ,采用食管癌切除器械吻合术。术后观察吻合口瘘、吻合口狭窄和胃食管反流并发症的发生率 ,并随访观察 3年。 结果 套接组术后吻合口瘘、吻合口狭窄和胃食管反流的发生率分别为 0 %、2 .2 %和 1.5 % ,而吻合组为 1.3%、13.9%和 2 1.2 % (P<0 .0 1)。 结论 食管瓣片成形 -食管胃套接术术后并发症少、操作简单 ,较器械吻合具有一定的优越性。

Objective To induce the complications after resection of esophageal and cardiac carcinoma and anastomosis by comparing the clinical effect of two difference methods of esophagogastrostomy. Methods 285 patients were divided into two groups according to the sequence of admission to hospital at random, wrap suturing group: 134 cases, using the wrap suturing, stapled anastomosis group:151 cases, using stapler. The incidence of postoperative complications, anastomotic leakage, anastomotic stricture and esophagogastric reflux, were observed and followed up 3 years. Results The incidence of anastomotic leakage, anastomotic stricture and esophagogastric reflux was 0%,2.2% and 1.5% in wrap suturing, in stapled anastomosis group was 1.3%, 13.9% and 21.2%. The statistic analysis showed the incidence of postoperative complications in wrap suturing group was lower than that of stapled anastomosis group (P<0.01). Conclusion The wrap suturing operation to cure esophageal and cardiac carcinoma had lower postoperative complications, was simple to operation and more superior to stapled anastomosis.