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目的改进食管胃吻合方式，降低吻合口瘘及狭窄的发生率。方法将５５２例食管、贲门癌患者随机分为３组，分别采用荷包式吻合；食管胃分层吻合；食管胃不同平面吻合，吻合口加盖大网膜或下肺韧带三种不同的吻合方式，比较各组吻合口瘘及狭窄的发生率。结果吻合口瘘发生率分别为：３．７５％，１．０９％和０；狭窄的发生率分别为：８．１％，３．２５％和０．９６％。三组结果有显著性差异。结论食管胃不同平面吻合，吻合口加盖大网膜或下肺韧带可有效预防食管胃吻合口瘘及狭窄的发生。
Objective To improve esophageal and gastric anastomosis and reduce the incidence of anastomotic fistula and stenosis. Methods 552 patients with esophageal and cardiac cancer were randomly divided into three groups, which were treated by purse-string anastomosis, esophagogastrostomy anastomosis, esophagogastric anastomosis, anastomosis with omentum or lower pulmonary ligament The incidences of anastomotic leakage and stenosis in each group were compared. Results The incidence of anastomotic fistula was 3.75%, 1.09% and 0 respectively. The incidence of stenosis was 8.1%, 3.25% and 0.96% respectively. Three groups of results have significant differences. Conclusion Esophagogastric anastomosis, anastomosis stamped with omentum or ligament of the lung can effectively prevent the occurrence of esophagogastric anastomotic fistula and stenosis.