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腔镜食管癌手术中颈部不同吻合方式对术后并发症的影响

The influence of different cervical anastomosis methods on complications during laparoscopic esophageal cancer surgery

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【作者】 程栋梁林称意郭家龙刘华松刘华

【Author】 CHENG Dongliang;LIN Chengyi;GUO Jialong;LIU Huasong;LIU Hua;Department of Thoracic Surgery,the Third People’s Hospital of Shenzhen;

【机构】 深圳市第三人民医院胸外科湖北省十堰市太和医院(湖北医药学院附属医院)胸心外科

【摘要】 目的 探讨胸腹腔镜联合食管癌根治术中颈部手工分层吻合和管形吻合器吻合对近期并发症的影响。方法 2019年2月~2022年4月我院行胸腹腔镜食管癌手术的病人196例,按胃-食管颈部吻合方式不同分为手工组(87例)和管吻组(109例),比较两组病人颈部手术时间、总手术时间、术后吻合口漏、吻合口狭窄等并发症的发生率,比较两组的治疗效果的差异。结果 管吻组病人颈部吻合时间[(23±3.57)分钟]短于手工组[(31±4.5)分钟],差异有统计学意义,但两组病人总体手术时间比较差异无统计学意义(P>0.05)。手工组病人术后吻合口漏、吻合口狭窄发生率低于管吻组,差异有统计学意义(P<0.05)。结论 在胸腹腔镜联合食管癌手术中,颈部手工分层吻合可降低术后吻合口并发症的发生率。

【Abstract】 Objective To investigate the effect of cervical manual stratified anastomosis and anastomosis with tube stapler on the recent complications in thoracic laparoscopy combined with radical resection of esophageal cancer.Methods From February 2019 to April 2022,a total of 196 patients who underwent endoscopic surgery for esophageal cancer who met the study criteria were divided into the manual group(87 cases) and the tubulostomy group(109 cases) according to the different ways of gastro-esophageal cervical anastomosis.The incidence of cervical surgery time, total operation time, postoperative anastomotic fistula, anastomotic stenosis and other complications of the two groups were evaluated, and the differences in treatment effects between the two groups were compared.Results The preoperative basic conditions of patients in the manual group and the tube kiss group were comparable, and the cervical anastomosis time in the tube kiss group[(23±3.57)min] was shorter than that in the manual group[(31±4.5)min](P<0.05),but there was no statistical significance in the overall operation time between the two groups(P>0.05).The comparison of postoperative anastomotic fistula and anastomotic stenosis between the two groups showed that the manual group was significantly lower than the tube kiss group, and the difference was statistically significant(P<0.05).Conclusion In thoracic laparoscopic combined with esophageal cancer surgery, cervical manual stratified anastomosis can reduce the incidence of postoperative anastomotic complications.

【基金】 湖北省自然科学基金项目(编号:2022CFB540)
  • 【文献出处】 临床外科杂志 ,Journal of Clinical Surgery , 编辑部邮箱 ,2023年12期
  • 【分类号】R735.1
  • 【下载频次】18
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