CAJ | 학술논문

目的：观察直线型缝合器重塑管状胃与手工吻合的手术效果，比较2种吻合方式对术后并发症的影响。方法回顾性分析92例食管癌手术治疗患者的临床资料，根据手术方式不同分为对照组（52例）和观察组（40例），前者术中采用传统手工吻合消化道，后者采用器械吻合重建消化道，比较2组患者手术时间、出血量及术后并发症等情况。结果围手术期未出现手术失败或死亡病例。观察组吻合时间低于对照组，观察组1例患者吻合口瘘，经充分引流后痊愈，对照组4例吻合口瘘，其中1例行空肠造瘘；2组吻合口瘘发生率具有显著差异（P＜0．05）。术后随访发现2组患者反流性食管炎发生率无显著差异，但对照组吻合口狭窄率显著高于观察组（ P＜0．05）。结论管状胃可有效延长胃长度，适用于食管癌切除胃食管吻合术，可缩短手术时间，降低术后吻合口瘘、吻合口狭窄等并发症风险。
목적：관찰직선형봉합기중소관상위여수공문합적수술효과，비교2충문합방식대술후병발증적영향。방법회고성분석92례식관암수술치료환자적림상자료，근거수술방식불동분위대조조（52례）화관찰조（40례），전자술중채용전통수공문합소화도，후자채용기계문합중건소화도，비교2조환자수술시간、출혈량급술후병발증등정황。결과위수술기미출현수술실패혹사망병례。관찰조문합시간저우대조조，관찰조1례환자문합구루，경충분인류후전유，대조조4례문합구루，기중1례행공장조루；2조문합구루발생솔구유현저차이（P＜0．05）。술후수방발현2조환자반류성식관염발생솔무현저차이，단대조조문합구협착솔현저고우관찰조（ P＜0．05）。결론관상위가유효연장위장도，괄용우식관암절제위식관문합술，가축단수술시간，강저술후문합구루、문합구협착등병발증풍험。
Objective To compare the clinical effect and complications between digestive tract reconstruction of gastric tube and manual cervical esophagogastric anastomosis following esophagectomy for esophageal cancer. Methods Clinical data of 92 patients with esophageal cancer were retrospectively studied. The patients were divided into the observation group ( n=40) and the control group(n=52) based on mechanical and manual cervical esophagogastric anastomosis. The operative time,blood vol-ume and incidence of postoperative complications were compared between the 2 groups.Results No one failed or died in the perioperative period. The operative time in the observation group were less than that of the control group. There were 1 and 4 cases of anastomotic leak in the observation group and the control group respectively. There had significant difference(P<0.05).Re-flux esophagitis of the 2 groups had no significant difference. The anastomotic stenosis rate in the control group were higher than that of the observation group (P<0.05).Conclusion Gastric tube can effectively extend the length of the stomach in esophage-ctomy for esophageal cancer, and it shortens operative time, reduces anastomotic fistula and anastomotic stenosis.