【摘要】 目的探讨在食管胃颈部吻合术中使用机械吻合并吻合口包埋的作用。方法回顾性分析101例患者行食管癌切除食管胃颈部吻合术的临床资料,总结并分析手术情况和术后并发症情况。结果 97例使用管状吻合器机械吻合并包套吻合口,2例因胃长度不够采用手工吻合,1例因吻合后张力较大未行包套,1例抵钉座尺寸过大撕裂食管肌层需要另行缝合,手术完成率96.0%(97/101)。术后2例出现吻合口或胃出血(2.1%),吻合口瘘4例(4.1%),经过清创引流后痊愈;无其他机械吻合并发症。术后3月CT和上消化道造影提示吻合口狭窄(<1.5 cm)2例,占2.1%,无<1 cm病例。存在吞咽困难症状共4例(4.1%),反流引发的反酸、口苦等口腔、咽部相关症状11例(11.3%)。结论管状吻合器胃腔内吻合安全、简便,宽松包套后有显著的抗反流作用。更多还原

【Abstract】 Objective To investigate the effect of embedded esophagogastric anastomosis with circular staplers in treatment of esophageal carcinoma.Methods 101 cases of esophageal carcinomas undergone cervical anastomoses after esophagectomy from March 2009 to March 2010 were retrospective reviewed.The clinical outcomes were analyzed.Results 97 cases were undergone embedded cervical anastomosis with circular staplers,and the complete operation were performed in 97 cases(96.0%).2 were performed hand-sewn anastomosis because of short stomachs,1 couldn′t perform embedding due to high tension,and another needed to suture the leakage caused by large stapler.Bleeding was found in 2 cases(2.1%),and fistula in 4 cases(4.1%).2 cases were found stoma strictures by CT or barium swallow 3 months later.4 patients(4.1%) complained of dysphagia,and 11(11.3%) of sour regurgitation or thirsty and bitterness.Conclusion Embedded cervical anastomosis with circular staplers is easy to perform and has definite anti-reflux effect for esophagogastric anastomosis.更多还原