Yan Ming, Chen Yu-Hang, Liu Xian-Ben, Shao Ling-Fang, Li Yin
Department of Thoracic Surgery, Henan Provincial Tumor Hospital, Zhengzhou, Henan, People's Republic of China.
Ai Zheng. 2009 Jul;28(7):768-70. doi: 10.5732/cjc.008.10633.
Anastomotic leakage and fibrous stenosis are significant complications of the cervical esophagogastric anastomosis although cervical esophagogastric anastomosis appears to decrease morbidity as compared with intrathoracic anastomosis. We modified the techniques of cervical esophagogastric anastomosis using circular stapler after resection of esophageal carcinoma, and evaluated its efficacy.
Between October 2006 and April 2008, 127 patients underwent esophagectomy using gastric tissues positioned in the original esophageal bed as esophageal substitute for reconstruction. Cervical esophagogastric anastomosis using circular stapler was performed in all patients. The occurrence of postoperative complications was recorded and analyzed.
No operation-related death and no anastomotic hemorrhage occurred. Anastomotic leakage developed in one patient (0.8%) because of instrumental failure; five patients (3.9%) developed fibrous stenosis that required stricture dilation.
Modified mechanical cervical esophagogastric anastomosis using circular stapler is effective and safe, and can reduce the occurrence of postoperative anastomotic complications.
尽管与胸内吻合相比，颈段食管胃吻合术似乎能降低发病率，但吻合口漏和纤维性狭窄仍是颈段食管胃吻合术的严重并发症。我们在食管癌切除术后采用圆形吻合器改良了颈段食管胃吻合技术，并评估了其疗效。
2006年10月至2008年4月期间，127例患者接受了食管切除术，使用位于原食管床的胃组织作为食管替代物进行重建。所有患者均采用圆形吻合器进行颈段食管胃吻合。记录并分析术后并发症的发生情况。
未发生与手术相关的死亡，也未发生吻合口出血。1例患者（0.8%）因器械故障发生吻合口漏；5例患者（3.9%）发生纤维性狭窄，需要进行狭窄扩张。
采用圆形吻合器改良的机械性颈段食管胃吻合术有效且安全，可减少术后吻合口并发症的发生。
