Aslam Viqar, Bilal Aamir, Khan Abid, Bilal Muhammad, Ahmed Manzoor
Department of Cardiothoracie Surgery, Lady Reading Hospital, Peshawar.
J Ayub Med Coll Abbottabad. 2008 Jul-Sep;20(3):6-9.
Considerable controversy exists regarding the optimum technique for gastroesophageal anastomosis. Double layer technique has long been considered important for safe healing but there is evidence that single layer technique is also safe and can be performed in much shorter time. The purpose of this study was to compare the outcome of single layer and double layer techniques for gastroesophageal anastomosis.
A prospective randomized study was conducted in cardiothoracic unit, Lady Reading Hospital from Jan 2006 to Jan 2008. Fifty patients with oesophageal carcinoma undergoing subtotal oesophagectomy were randomized to have the anastomosis by single layer continuous or double layer continuous technique (group A (n=24) and B (n=26) respectively). The demographic data, operative and anastomosis time, postoperative complications and hospital mortality were recorded on a proforma and analyzed on SPSS 10.
There was no significant difference between group A and B in terms of age, gender, postoperative complications and duration of hospital stay. Anastomotic leak occurred in 4.2% patients in group A and 7.7% in group B (p=NS). Mean anastomosis time was 10.04 minutes in group A and 19.2 minutes in group B (p = 0.0001). Mean operative time was 163.83 minutes and 170.96 minutes in group A and B respectively. Overall hospital mortality was 2%; no deaths occurred due to anastomotic leak.
Single layer continuous technique is equally safe and can be performed in shorter time and at a lower cost than the double layer technique.
关于胃食管吻合术的最佳技术存在相当大的争议。双层技术长期以来一直被认为对安全愈合很重要，但有证据表明单层技术也是安全的，并且可以在更短的时间内完成。本研究的目的是比较单层和双层技术在胃食管吻合术中的效果。
2006年1月至2008年1月在雷丁夫人医院心胸外科进行了一项前瞻性随机研究。50例接受食管次全切除术的食管癌患者被随机分为单层连续或双层连续技术进行吻合（分别为A组（n = 24）和B组（n = 26））。在一份表格上记录人口统计学数据、手术和吻合时间、术后并发症及医院死亡率，并在SPSS 10上进行分析。
A组和B组在年龄、性别、术后并发症和住院时间方面无显著差异。A组4.2%的患者发生吻合口漏，B组为7.7%（p = 无统计学意义）。A组平均吻合时间为10.04分钟，B组为19.2分钟（p = 0.0001）。A组和B组的平均手术时间分别为163.83分钟和170.96分钟。总体医院死亡率为2%；无因吻合口漏导致的死亡。
单层连续技术同样安全，与双层技术相比，可以在更短的时间内以更低的成本完成。
