中华消化外科杂志
中華消化外科雜誌
중화소화외과잡지
CHINESE JOURNAL OF DIGESTIVE SURGERY
2013年
1期
38-41
,共4页
李海波%肖波%方强%任光国%曹伯雄
李海波%肖波%方彊%任光國%曹伯雄
리해파%초파%방강%임광국%조백웅
食管肿瘤%食管肿瘤切除术%食管胃颈部吻合%机械吻合%手工吻合
食管腫瘤%食管腫瘤切除術%食管胃頸部吻閤%機械吻閤%手工吻閤
식관종류%식관종류절제술%식관위경부문합%궤계문합%수공문합
Esophageal neoplasms%Esophageal cancer resection%Esophagogastric cervical anastomosis%Stapled suture%Manual suture
目的 评价机械吻合与手工吻合在食管癌切除术颈部吻合中的应用价值.方法 本研究回顾性分析2010年1月至2012年1月四川省肿瘤医院收治的187例食管癌患者的临床资料,根据行食管癌切除术后颈部吻合的方式不同分为机械吻合组(98例)和手工吻合组(89例),比较两组患者吻合时间、总手术时间、术后开始进食时间、住院时间、术后并发症发生率及食管残端癌阳性率的差异,计量资料采用t检验,计数资料采用x2检验或Fisher确切概率法.结果 机械吻合组患者吻合时间、总手术时间、术后开始进食时间及住院时间分别为(7.8±1.4)min、(227±60) min、(6.3±0.9)d、(14±4)d,短于手工吻合组的(28.5±2.3) min、(301±81) min、(8.4±1.0)d、(22±9)d,两组比较,差异有统计学意义(t=75.44,7.14,7.71,7.41,P＜0.05)；机械吻合组患者术后吻合口瘘发生率为1％ (1/98),低于手工吻合组的8％(7/89),两组比较,差异有统计学意义(P＜0.05)；两组吻合口狭窄发生率分别为5％ (5/98)和7％ (6/89),两组比较,差异无统计学意义(P＞0.05)；机械吻合组无食管残端癌,手工吻合组食管残端癌阳性率为4％(4/89),两组比较,差异有统计学意义(P＜0.05).结论 机械吻合在食管癌颈部吻合中不仅能缩短吻合时间、总手术时间及住院时间,而且能降低吻合口瘘发生率和食管残端癌阳性率.
目的 評價機械吻閤與手工吻閤在食管癌切除術頸部吻閤中的應用價值.方法 本研究迴顧性分析2010年1月至2012年1月四川省腫瘤醫院收治的187例食管癌患者的臨床資料,根據行食管癌切除術後頸部吻閤的方式不同分為機械吻閤組(98例)和手工吻閤組(89例),比較兩組患者吻閤時間、總手術時間、術後開始進食時間、住院時間、術後併髮癥髮生率及食管殘耑癌暘性率的差異,計量資料採用t檢驗,計數資料採用x2檢驗或Fisher確切概率法.結果 機械吻閤組患者吻閤時間、總手術時間、術後開始進食時間及住院時間分彆為(7.8±1.4)min、(227±60) min、(6.3±0.9)d、(14±4)d,短于手工吻閤組的(28.5±2.3) min、(301±81) min、(8.4±1.0)d、(22±9)d,兩組比較,差異有統計學意義(t=75.44,7.14,7.71,7.41,P＜0.05)；機械吻閤組患者術後吻閤口瘺髮生率為1％ (1/98),低于手工吻閤組的8％(7/89),兩組比較,差異有統計學意義(P＜0.05)；兩組吻閤口狹窄髮生率分彆為5％ (5/98)和7％ (6/89),兩組比較,差異無統計學意義(P＞0.05)；機械吻閤組無食管殘耑癌,手工吻閤組食管殘耑癌暘性率為4％(4/89),兩組比較,差異有統計學意義(P＜0.05).結論 機械吻閤在食管癌頸部吻閤中不僅能縮短吻閤時間、總手術時間及住院時間,而且能降低吻閤口瘺髮生率和食管殘耑癌暘性率.
목적 평개궤계문합여수공문합재식관암절제술경부문합중적응용개치.방법 본연구회고성분석2010년1월지2012년1월사천성종류의원수치적187례식관암환자적림상자료,근거행식관암절제술후경부문합적방식불동분위궤계문합조(98례)화수공문합조(89례),비교량조환자문합시간、총수술시간、술후개시진식시간、주원시간、술후병발증발생솔급식관잔단암양성솔적차이,계량자료채용t검험,계수자료채용x2검험혹Fisher학절개솔법.결과 궤계문합조환자문합시간、총수술시간、술후개시진식시간급주원시간분별위(7.8±1.4)min、(227±60) min、(6.3±0.9)d、(14±4)d,단우수공문합조적(28.5±2.3) min、(301±81) min、(8.4±1.0)d、(22±9)d,량조비교,차이유통계학의의(t=75.44,7.14,7.71,7.41,P＜0.05)；궤계문합조환자술후문합구루발생솔위1％ (1/98),저우수공문합조적8％(7/89),량조비교,차이유통계학의의(P＜0.05)；량조문합구협착발생솔분별위5％ (5/98)화7％ (6/89),량조비교,차이무통계학의의(P＞0.05)；궤계문합조무식관잔단암,수공문합조식관잔단암양성솔위4％(4/89),량조비교,차이유통계학의의(P＜0.05).결론 궤계문합재식관암경부문합중불부능축단문합시간、총수술시간급주원시간,이차능강저문합구루발생솔화식관잔단암양성솔.
Objective To evaluate the efficacy of circinal stapled suture and manual suture in cervical esophagogastric anastomosis in esophageal resection.Methods The clinical data of 187 patients with esophageal cancer who were admitted to the Cancer Hospital of Sichuan Province from January 2010 to January 2012 were retrospectively analyzed.All the patients were divided into the stapled suture group (98 patients) and manual suture group (89 patients).The time of anastomosis,operation time,time for dieting,duration of hospital stay,the incidence of postoperative complications and positive rate of esophageal remnant cancer cells of the 2 groups were compared.All data were analyzed using the t test or chi-square test.Results The time of anastomosis,operation time,time for dieting and duration of hospital stay were (7.8 ± 1.4) minutes,(227 ± 60) minutes,(6.3 ± 0.9) days and (14 ±4)days in the stapled suture group,which were significantly shorter than (28.5 ±2.3)minutes,(301 ±81)minutes,(8.4 ± 1.0)days and (22 ±9) days in the manual suture group (t =75.44,7.14,7.71,7.41,P ＜0.05).The incidence of anastomotic fistula was 1％ (1/98) in the stapled suture group,which was significantly lower than 8％ (7/89) of the manual suture group (P ＜ 0.05).The incidence of anastomotic stricture was 5％(5/98) in the stapled suture group,which was lower than 7％ (6/89) in the manual suture group,but no significant difference was detected (P ＞0.05).The positive rate of esophageal remnant cancer cells was 0(0/98),which was signifiantly lower than 4％ (4/89) in the manual suture group (P ＜0.05).Conclusion Circinal stapled suture in esophagogastric cervical anastomosis not only reduce the time of anastomosis,operation time and duration of hospital stay,but also decrease the incidence of anastomotic fistula and the positive rate of esophageal remnant cancer cells.
