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目的评价国产吻合器和闭合器在食管癌消化道重建术中的应用价值。方法回顾性分析2005年3月2008年4月期间收治的387例食管癌手术患者的临床资料,根据不同消化道重建方式分为手工吻合组(n=172)和器械吻合组(n=215),对两组患者吻合时间、术中出血量及术后并发症发生情况进行对比分析。结果全组无手术死亡。器械吻合组和手工吻合组术中出血量的差别无统计学意义(P>0.05),但前者的吻合时间、住院时间均少于后者(P<0.05)。手工吻合组术后吻合口出血多于器械吻合组(5.2%比1.4%,P<0.05),发生吻合口漏亦多于器械吻合组(6.4%比2.8%,P<0.05)。随访1.5～2年,排除失访患者后,器械吻合组吻合口狭窄发生率低于手工吻合组(4.6%比10.3%,P<0.05)。结论国产吻合器与和缝合器用于食管癌的消化道重建安全有效,值得在基层医院推广应用。
Objective To evaluate the value of domestic stapler and occluder in the gastrointestinal tract reconstruction of esophageal cancer. Methods The clinical data of 387 esophageal cancer patients who underwent surgery in March 2005 and April 2008 were retrospectively analyzed. According to different methods of digestive tract reconstruction, they were divided into manual anastomosis group (n = 172) and mechanical anastomosis group (n = 215) , The two groups of patients with anastomosis time, intraoperative blood loss and postoperative complications were compared. Results All patients died without surgery. There was no significant difference in the amount of bleeding in the anastomosis group and manual anastomosis group (P> 0.05). However, the anastomosis time and hospitalization time of the former group were less than the latter (P <0.05). There was more anastomotic leakage in the manual anastomotic group than in the mechanical anastomosis group (5.2% vs 1.4%, P <0.05). The follow-up of 1.5 to 2 years, excluding patients lost, the anastomotic stenosis rate was lower in the anastomosis group than in the manual anastomosis group (4.6% vs. 10.3%, P <0.05). Conclusion Domestic stapler and stapler are safe and effective for gastrointestinal reconstruction of esophageal cancer, which is worth popularizing and applying in primary hospital.