【摘要】 目的比较食管癌手术中采用分层缝合或全层内翻吻合法,术后胃食管吻合口瘘及狭窄的发生情况。方法722例被临床确诊的Ⅰ或Ⅱ(Ⅱa和Ⅱb)期食管癌患者,从2002年6月至2007年1月有235例采用胃食管分层缝合,从1990年1月至2002年5月有487例患者采用全层内翻吻合的方法,回顾性分析24个月内的随访资料,特别是吻合口瘘及狭窄等并发症的发生率。结果分层缝合与全层内翻吻合的患者,术后吻合口瘘和狭窄的发生率分别为0%、0.85%(2/235)和5.1%(25/487)、6%(28/487),差异有统计学意义(P<0.01)。结论胃食管分层缝合明显降低了食管癌术后吻合口瘘和狭窄的发生,优于传统的器械或手工行全层内翻吻合方法。更多还原

【Abstract】 Objective To compare the incidence of postoperative leak and stenosis adopted the layered hand-sewn(LHS)or full layer varus anastomosis(FLVA)method in esophagogastric anastomosis.Methods 722 patients with clinical stage Ⅰ and Ⅱ(Ⅱa and Ⅱb)esophageal carcinoma met the enrollment criteria.235 patients were surgically treated by LHS from June 2002 to January 2007 and 487 patients by FLVA from January 1990 to May 2002.Collective data on the operative procedures and the subsequently postoperative complications,anastomotic leak and stenosis in 24 months were retrospectively analyzed in all the patients.Results As for the complications of postoperative anastomotic leak and stenosis,the incidence were 0% and 5.1%(25/487)on LHS,while 0.85%(2/235)and 6%(28/487)on FLVA.The statistical difference was significant(P<0.01).Conclusion The new esophagogastric anastomosis method,LHS,has more advantages to reduce postoperative complications of anastomotic leak and stricture than conventional FLVA by stapled or hand-sewen.更多还原