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目的比较胸中上段食管癌切除术中食管-胃左颈部机械吻合与手工吻合的效果。方法选择2009年1月至2013年9月收治的胸中上段食管癌患者219例,其中采用胃-食管左颈部机械吻合115例,手工吻合104例。比较两种吻合方式术后并发症的发生率,评价两种吻合方式的手术疗效。结果机械吻合组、手工吻合组的吻合时间分别为(14.5±6.0)、(43.0±9.5)min;吻合口瘘分别7(6.1%)、13(12.5%)例;吻合口狭窄分别9(7.8%)、18(17.3%)例,差异均有统计学意义(P均<0.05)。而两组颈部引流量、吻合口出血、声音嘶哑、肺部并发症、死亡发生率比较差异均无统计学意义(P均>0.05)。结论食管-胃左颈部机械吻合法与手工吻合法相比,可有效缩短吻合时间,减少术后并发症,提高患者术后生活质量,有利于患者康复。
Objective To compare the effect of mechanical anastomosis and manual anastomosis of the esophagus - stomach left neck in the upper thoracic esophagectomy. Methods A total of 219 patients with upper thoracic esophageal cancer who were admitted from January 2009 to September 2013 were selected, including 115 cases of mechanical esophageal anastomosis of the stomach and esophagus and 104 cases of manual anastomosis. The incidence of postoperative complications of the two anastomosis methods was compared, and the surgical effect of the two anastomosis methods was evaluated. Results The anastomosis time of mechanical anastomosis group and manual anastomosis group were (14.5 ± 6.0) and (43.0 ± 9.5) min respectively, and the anastomotic fistula were 7 (6.1%) and 13 (12.5% %), 18 (17.3%) cases, the differences were statistically significant (P all <0.05). The two groups of neck drainage, anastomotic bleeding, hoarseness, pulmonary complications, the incidence of death was no significant difference (P all> 0.05). Conclusion Compared with manual anastomosis, the esophago-gastric left-neck mechanical anastomosis can shorten the time of anastomosis, reduce the postoperative complications and improve the postoperative quality of life, which is benefit to the patients’ rehabilitation.