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食管重建术吻合术式的临床研究 |
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郑海波 李学明 吴智勇
［摘要］目的 研究延长食管胃粘膜吻合(新术式)、吻合器吻合、传统术式吻合三种不同食管重建术式对吻合口瘘和吻合口狭窄的影响。方法 1996年3月～1998年3月对食管贲门癌切除食管重建术者采用新术式241例，颈吻合24例，胸内吻合217例；吻合器吻合110例，均为胸内吻合；1995年3月～1996年 3月采用传统术式211例，颈吻合22例，胸内吻合189例。结果 传统术式发生吻合口瘘3例，颈部、弓上、弓下吻合各1例，新术式组及吻合器组均无。无重度吻合口狭窄，吻合器组3例并发轻至中度狭窄，传统术式2例，新术式组无。结论 采用新术式在操作上容易使吻合口粘膜对合整齐，可避免多种致瘘因素及有效预防吻合狭窄。
［关键词］食管癌；贲门癌；吻合口瘘；吻合口狭窄
［分类号］R655.4 ［文献标识码］A
［文章编号］1005-6483(2000)02-0098-02
A clinical research on esophagogastric anastomosis techniques for esophagus reconstruction
ZHENG Haibo，LI Xueming，WU Zhiyong.
（Department of Oncology,Shangtou Central Hospital,Guangdong 515031，China）
［Abstract］Objective To research three kinds of esophagogastric anastomosis techniques for esophagus reconstruction such as extended esophagogastric mucosa anastomosis(EEMA),instrumental anastomosis(IA) and tranditional anastomosis(TA).Their influences on anasyomotic leakage and stenosos were compared.Methods Between March 1996 to March1998,EEMA was performed in 241 cases of cardial or esophageal carcinoma after lesion resection,including 24 cervical anastomosis and 217 intrathoracic anastomosis.110 cases underwent IA intrathoracically in the same period.Between March 1995 to March 1996,22 cases of cervical anastomosis and 189 intrathoracic anastomosis,totally 211 cases,were performed using TA.Results 3 cases of anastomotic leakage occured in TA group shared by cervical,supraaortic and infraaortic anastomosis but none in EEMA of IA group.No severe anastomotic stenosis occured in the three groups.There were 3 cases in IA and 2 cases in TA group of slight to moderate anastomotic stenosis,but none in EEMA.Conclusion The method of EEMA is likely to make it easier for mucosa conjunction so as to prevent aspects of elements eliciting anastomotic leakage and avoid anastomotic asenosis effectively.
［Key words］Esophageal neoplasms；Cardial neoplasms；Anastomotic leakage； Anastomotic stenosis
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