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比较食管-胃吻合口三种不同加固方法的吻合口瘘发生率
作者:蒋修全  陈朝奇  郑伟  左天理  杨铁  唐海军 
单位:川北医学院附属三台医院胸外科  四川 绵阳 621100 
关键词:食管肿瘤/外科学 手术后并发症 吻合术 外科/方法 吻合术 外科/仪器和设备  
DOI:10.13267/j.cnki.syzlzz.2019.01.017
出版年,卷(期):页码:2019,34(1):75-78
摘要:

目的 探讨三种不同的食管-胃吻合口加固处理方法对食管癌术后吻合口瘘发生率的影响。方法 选择经左胸食管-胃端侧弓上机械吻合手术患者438例,根据食管-胃吻合口不同的加固处理方法分为3组,A组(n=190)在食管胃端侧机械吻合术后采用悬吊减张处理吻合口;B组(n=114)在食管胃端侧机械吻合术后采用间断全层加强缝合处理吻合口;C组(n=134)采用间断全层加强缝合+大网膜再次包埋的方法处理吻合口。分析不同的加固处理方法对食管-胃吻合口瘘发生率的影响。结果 A组、B组和C组吻合口瘘发生率,组间两两比较,差异均无统计学意义(均P>0.05)。结论 食管癌弓上机械吻合术后采用3种不同吻合口加固处理方法,吻合口瘘发生率无差别。

Objective To investigate the effects of three different methods of esophagogastric anastomosis reinforcement on the incidence of anastomotic leakage after esophagectomy. Methods A total of 438 patients who underwent mechanical supraarch anastomosis through the left thoracic esophagus and stomach end were enrolled. According to different reinforcement methods of esophagogastric anastomosis,the patients were divided into three groups.Group A (n=190) was treated with suspension and tension reduction after mechanical anastomosis at the end of esophagus and stomach,group B (n=114) was treated with intermittent full-layer enhanced suture after mechanical anastomosis at the end of esophagus and stomach,and group C (n=134) was treated with intermittent full-layer reinforced suture plus large omentum re-embedding.The influence of different reinforcement methods on the incidence of esophagogastrostomy fistula was analyzed afterwards. Results There was no significant difference between any two groups among the three experimental groups in the incidence of anastomotic leakage(all P>0.05). Conclusion The incidence of anastomotic leakage after mechanical anastomosis of esophageal carcinoma was similar with the three anastomotic reinforcement methods examined in our study.

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