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目的评价颈胸腹三切口食管癌术、食管-胃左颈部机械吻合的应用价值。方法选择2003年4月～2007年7月来我院就诊的120例胸中、上段食管癌患者作为研究对象,采用颈胸腹三切口食管癌切除术、食管-胃左颈部吻合术等方法进行治疗,按术中采用吻合方式的不同将其分为手工吻合组与机械吻合组,比较2组的总手术时间,食管-胃吻合时间,手术后吻合口瘘、吻合口狭窄、吻合口出血的发生率。结果机械吻合组的总手术时间、食管-胃吻合时间较手工吻合组明显缩短(P<0.01),手术后吻合口瘘、吻合口狭窄、吻合口出血的发生率均较手工吻合组低(P<0.05)。结论颈胸腹三切口食管癌切除术、食管-胃左颈部机械吻合能明显缩短总手术时间及食管-胃吻合时间,有效降低手术后吻合口瘘、吻合口狭窄、吻合口出血的发生率,提高患者手术后的生活质量,有利于患者康复。
Objective To evaluate the clinical value of cervical thoracoabdominal and abdominal triple incision esophagectomy and esophageal-gastric left-neck mechanical anastomosis. Methods From April 2003 to July 2007, 120 cases of upper thoracic and upper esophageal cancer patients treated in our hospital from April 2003 to July 2007 were enrolled in this study. The patients underwent resection of the thoracic and abdominal triple incision esophageal cancer and esophagogastric left anastomosis The patients were divided into manual anastomosis group and mechanical anastomosis group according to the different anastomosis methods during operation. The total operation time, esophageal-gastric anastomosis time, anastomotic fistula, anastomotic stenosis and anastomotic bleeding were compared between the two groups Occurrence rate. Results The total operation time and esophageal - gastric anastomosis time in mechanical anastomosis group were significantly shorter than those in manual anastomosis group (P <0.01). The incidences of anastomotic fistula, anastomotic stenosis and anastomotic bleeding after operation were lower than those of manual anastomosis group (P <0.05). Conclusions The resection of cervico-thoracoabdominal and abdominal triple-incision esophagectomy and esophageal-gastric left-neck mechanical anastomosis can shorten the total operation time and esophageal-gastric anastomosis time effectively and reduce the incidence of anastomotic fistula, anastomotic stenosis and anastomotic bleeding after operation , Improve the quality of life of patients after surgery, is conducive to patient rehabilitation.