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目的 探讨机械吻合在颈段食管中的临床应用。方法 对 76例食管癌病人 ,术前病理诊断为鳞癌 74例 ,腺癌 2例。其中病变位于上段 12例 ,中段 4 8例 ,中下段 16例。手术时将全胸段及腹段食管切除 ,用消化道吻合器 ,经胸腔将颈段食管与胃作端侧吻合。术后 2 0h开始肠内滴注能全力。结果 全组病例均一次吻合完成 ,术后无一例出现吻合口瘘 ,无乳糜胸或喉返神经损伤等并发症。无手术死亡。结论 机械吻合具有操作简便、安全、可靠等优点 ,通过技术改进 ,也可用于颈段食管与胃吻合。术后早期肠内营养能提高机体免疫力 ,减少并发症发生。
Objective To investigate the clinical application of mechanical anastomosis in cervical esophagus. Methods 76 cases of esophageal cancer patients, preoperative pathological diagnosis of squamous cell carcinoma in 74 cases, 2 cases of adenocarcinoma. Including lesions in the upper 12 cases, the middle 48 cases, 16 cases in the lower. The surgery will be the entire thoracic and abdominal esophagectomy, with gastrointestinal stapler, the thoracic cervical esophagus and stomach for end-to-end anastomosis. Intestinal drip can be started after 20h. Results All the patients were anastomosed one time. No anastomotic fistula occurred after operation, and no complications such as chylothorax or recurrent laryngeal nerve were found. No surgery died. Conclusions Mechanical anastomosis has the advantages of easy operation, safety, reliability and so on. It can also be used for anastomosis of cervical esophagus and stomach through technical improvement. Early postoperative enteral nutrition can improve the body immunity, reduce complications.