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目的评价食管癌手术中采用器械吻合的应用价值。方法选择我院1988年1月~2002年12月15年间需行食管癌、贲门癌切除术患者568例,按术中采用手工吻合或器械吻合分为手工吻合组和器械吻合组,比较两组术后情况及与吻合技术相关的并发症发生率。结果器械吻合组胃食管吻合时间、总手术时间、术后开始进食时间均较手工吻合组缩短(P<0.01),而术后住院时间两组差别无统计学意义;吻合口瘘、吻合口狭窄、吻合口出血、呼吸循环并发症发生率和围手术期死亡率器械吻合组均较手工吻合组低(2.1%、1.4%、0%、2.8%和0.7%vs.6.8%、4.3%、1.4%、16.5%和2.9%),两组患者胃食管反流差别无统计学意义(P>0.05)。结论器械吻合能明显缩短食管胃吻合时间及总手术时间,有效降低术后并发症发生率。
Objective To evaluate the value of instrument fit in esophageal cancer surgery. Methods 568 patients undergoing esophageal and cardiac resections in our hospital from January 1988 to December 2002 were divided into manual anastomosis and mechanical anastomosis according to manual or mechanical anastomosis, Postoperative condition and the incidence of complications associated with anastomosis. Results The time of gastrojejunal anastomosis, total operation time and postoperative feeding time were shorter in the anastomosis group than in the manual anastomosis group (P <0.01), but there was no significant difference in the postoperative hospital stay between the two groups. Anastomotic fistula and anastomotic stenosis (2.1%, 1.4%, 0%, 2.8% and 0.7% vs.6.8%, 4.3% and 1.4% respectively), anastomosis bleeding, complication rate of respiratory cycle and perioperative mortality rate %, 16.5% and 2.9%, respectively). There was no significant difference in gastroesophageal reflux between the two groups (P> 0.05). Conclusions Device anastomosis can significantly shorten the esophageal and gastric anastomosis time and total operation time, reduce the incidence of postoperative complications.