改良套入式包埋吻合术在食管癌根治术中的应用

摘要

Objective To compare application results between improved telescopic embedding anastomosis (TEA) and traditional surgery in radical resection of esophageal cancer.Methods A total of 120 esophageal cancer patients were assigned to observation (n=42) and control group (n=78) according to embedding styles.Both groups received laparothoracoscopy McKeown or Sweet operation, improved TEA was used for the observation, traditional interrupted horizontal mattress embedding anastomosis for the control, and perioperative general indexes were observed and compared between 2 groups.Results The anastomosed time was shorter (P<0.01), the incidence of stomas fistula lower (P<0.01) and that of stomas stenosis higher (P<0.01) in observation than in control group;group difference in the incidence of complications had no statistical significance (P>0.05).group difference in the death rate in 30 days after operation had no statistical significance (P>0.05).Conclusion Compared with traditional surgery improved TEA could notably shorten anastomosed time and lower the incidence of stomas fistula.%目的 比较改良套入式包埋吻合术与传统手术在食管癌根治术中的应用效果. 方法 将120例食管癌患者根据包埋方式分为观察组(42例)和对照组(78例).两组患者均行胸腹腔镜McKeown术式或Sweet术式,观察组采用改良套入包埋吻合口,对照组采用传统间断水平褥式包埋吻合口,观察比较两组围术期一般指标.结果 观察组术中吻合时间显著少于对照组(P<0.01),吻合口瘘发生率显著低于对照组(P<0.05),吻合口狭窄发生率显著高于对照组(P<0.01);两组其他并发症发生率比较差异无统计学意义(P>0.05).术后30 d,两组死亡率比较差异无统计学意义(P>0.05).结论 与传统手术相比,改良套入式包埋吻合术能显著缩短手术吻合时间,降低吻合口瘘发生率,在食管癌根治术中应用效果显著.