摘要
目的探讨大网膜包埋吻合口在全胸腔镜下食管胃胸内吻合术治疗食管癌中的临床价值。方法采用前瞻性研究方法,选取2014年3月至2017年8月在西安医学院第二附属医院手术治疗的食管癌患者80例,按照随机平行分组法随机分为两组,观察组(n=40)选择大网膜瓣袖套式包埋吻合术治疗,对照组(n=40)选择单纯吻合术治疗。比较两组患者术后以及远期并发症发生率、住院时间和吻合口良性狭窄时间。结果观察组患者吻合口瘘发生率(0)明显低于对照组(7. 5%)(P <0. 05),吻合口狭窄发生率(5. 0%)均明显低于对照组(17. 5%)(P <0. 05)。观察组患者肺部并发症发生率(15. 0%)、胸腔以及腹腔感染发生率(5. 0%)与对照组相比(17. 5%、7. 5%),差异无统计学意义(P> 0. 05)。观察组患者平均住院时间[(20. 33±10. 18) d]以及术后至吻合口良性狭窄时间[(3. 58±1. 02) d]与对照组[(23. 69±12. 77) d、(3. 24±1. 11) d]相比,差异无统计学意义(P> 0. 05)。结论全胸腔镜下食管癌根治切除术中以大网膜包埋方式完成食管胃胸内吻合治疗,能够有效减少吻合口瘘以及吻合口狭窄,患者康复的临床效果较为理想。
Objective To investigate the clinical value of the omental wrapping anastomosis in total thoracoscopic esophagogastrostomy for esophageal cancer.Methods Eighty patients with esophageal cancer who performed operation in the Second Affiliated Hospital of Xi'an Medical College from March 2014 to August 2017 were randomly divided into two groups.The observation group(n=40)was treated with omental wrapping anastomosis and the control group(n=40)was treated with simple anastomosis.The postoperative and long-term complications,hospitalization time and benign anastomotic stenosis time between the two groups were compared.Results Anastomotic fistula(0)in the observation group was significantly lower than that in the control group(7.5%)(P<0.05),and the incidence of anastomotic stenosis(5.0%)was significantly lower than that in the control group(17.5%)(P<0.05).There was no significant difference(P>0.05)between the observation group and the control group(17.5%,7.5%).The mean length of hospital stay in the observation group[(20.33±10.18)d]and the postoperative time to benign anastomotic stenosis[(3.58±1.02)d]and the control group[(23.69±12.77)d,(3.24±1.11)d]showed no significant difference(P>0.05).Conclusion In total thoracoscopic radical resection of esophageal carcinoma,esophagogastric intrathoracic anastomosis with omental wrapping anastomosis,can effectively reduce anastomotic fistula and anastomotic stenosis.
作者
孙志红
陈鑫
SUN Zhi-hong;CHEN Xin(Department of Thoracic Surgery,Second Affiliated Hospital of Xi 'an Medical University,Xi'an Shaanxi 710038,China)
出处
《临床和实验医学杂志》
2019年第8期859-861,共3页
Journal of Clinical and Experimental Medicine
基金
陕西省科技厅社会发展科技攻关项目(编号:2016SF-248)
关键词
食管癌
全胸腔镜
食管胃胸内吻合术
大网膜包埋吻合口
Esophageal cancer
Total thoracoscopy
Esophagogastrothoracic anastomosis
Omental wrapping anastomosis
