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目的比较机械吻合术与分层吻合术在预防食管和贲门癌手术后吻合口瘘、吻合口狭窄和食管反流并发症发生率的差异。方法将316例食管和贲门癌患者按入院顺序随机分为机械吻合组(162例,采用食管癌切除机械吻合术)和分层吻合组(154例,采用食管癌切除食管胃分层吻合术)。分别比较两组术后吻合口瘘、吻合口狭窄和食管反流并发症发生率。结果机械吻合组术后吻合口瘘和吻合口狭窄发生率分别为1.2%和2.0%,而分层吻合组则分别为3.9%和4.7%,两组比较P<0.01。两组胃食管反流的发生率(88.8%、89.3%)差异无统计学意义(P>0.05)。结论对于预防食管和贲门癌手术后吻合口瘘、吻合口狭窄方面,机械吻合优于分层吻合法。
Objective To compare the differences of anastomotic fistula, anastomotic stenosis and esophageal reflux complications between mechanical anastomosis and stratified anastomosis in the prevention of esophageal and cardiac cancer operation. Methods 316 patients with esophageal and cardiac cancer were randomly divided into mechanical anastomosis group (162 cases, mechanical esophagectomy with esophageal resection) and stratified anastomosis group (154 cases, esophagectomy and esophagogastrostomy) . The postoperative anastomotic leakage, anastomotic stenosis and esophageal reflux complications were compared between the two groups. Results The incidences of anastomotic fistula and anastomotic stenosis in mechanical anastomosis group were 1.2% and 2.0% respectively, while those in stratified anastomosis group were 3.9% and 4.7% respectively, P <0.01. The incidence of gastroesophageal reflux (88.8%, 89.3%) in the two groups showed no significant difference (P> 0.05). Conclusion Mechanical anastomosis is better than stratified anastomosis in preventing anastomotic fistula and anastomotic stricture after esophageal and gastric cardia surgery.