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目的:研究21 mm和25 mm圆形吻合器与食管癌颈部吻合口狭窄的关系。方法:回顾性总结河南省人民医院胸外科2008年1月至2013年6月行胃食管颈部机械吻合术的402例食管癌患者,分析21 mm和25 mm圆形吻合器与吻合口狭窄的关系。结果:发生吻合口狭窄54例,狭窄率为13.40%(54/402);吻合口瘘发生率为7.71%(31/402),吻合口瘘的患者中,吻合口狭窄发生率为29.03%(9/31)。在排除吻合口瘘等导致的狭窄后,胃侧荷包缝合组与无荷包缝合组之间吻合口狭窄发生率差异具有统计学意义(P<0.05)。胃侧荷包缝合组中21 mm吻合器吻合组与25 mm吻合器吻合组之间吻合口狭窄发生率差异不具有统计学意义(P>0.05);无荷包缝合组中21 mm吻合器吻合组与25 mm吻合器吻合组之间吻合口狭窄发生率差异不具有统计学意义(P>0.05)。结论:食管癌颈部吻合术中胃侧荷包缝合可有效降低术后吻合口狭窄发生率;术中使用的21 mm和25 mm圆形吻合器与术后吻合口狭窄发生率无关。
Objective: To study the relationship between 21 mm and 25 mm circular staplers and cervical anastomotic stenosis of esophageal cancer. Methods: A total of 402 esophageal cancer patients who underwent gastroesophageal neck mechanical anastomosis from January 2008 to June 2013 in Henan Provincial People’s Hospital were retrospectively reviewed. The 21 mm and 25 mm circular staplers and anastomotic stenosis relationship. Results: The anastomotic stenosis occurred in 54 cases, the stenosis rate was 13.40% (54/402). The incidence of anastomotic fistula was 7.71% (31/402). The incidence of anastomotic stenosis was 29.03% 9/31). After excluding the stenosis caused by anastomotic fistula, there was significant difference in the incidence of anastomotic stenosis between the stomach-purse suture group and the non-purse-suture group (P <0.05). There were no significant differences in the incidence of anastomotic stenosis between the 21 mm stapler anastomosis group and the 25 mm stapler anastomosis group in the gastric purse suture group (P> 0.05). The 21 mm stapler anastomosis group There was no significant difference in the incidence of anastomotic stenosis between 25 mm stapler anastomosis group (P> 0.05). Conclusion: Gastric purse suture in esophagectomy for neck anastomosis can effectively reduce the incidence of anastomotic stenosis. The 21 mm and 25 mm circular staplers used in this study have no relation with the incidence of anastomotic stenosis.