Department of Otolaryngology-Head and Neck Surgery, Oregon Health and Science University, Portland, Oregon, USA.
Head Neck. 2012 May;34(5):721-6. doi: 10.1002/hed.21806. Epub 2011 Jul 7.
The aim of this study was to demonstrate the technical feasibility and potential benefits of using a circular mechanical stapler with free jejunal transfer for jejunoesophageal anastomosis in total laryngopharyngectomy reconstruction while comparing the rates of fistula and stricture.
This study was a retrospective review of 12 free jejunal flaps completed with circular mechanical stapler for the jejunoesophageal anastomosis with comparison to 17 jejunal free flaps where all anastomoses were hand sewn.
In all, 29 patients underwent free jejunal transfer: 12 had jejunal free flap with circular mechanical stapler for jejunoesophageal anastomosis, whereas 17 patients had hand-sewn anastomosis. Corresponding rates of fistula and stricture were 0/12 fistulas and 3/12 strictures in the stapler cohort and 2/17 fistulas with 0/17 strictures in the hand-sewn cohort. No statistically significant difference in rate of fistula was observed between each cohort, whereas a trend toward increased rate of stricture (p = .06) was observed in the stapled anastomosis cohort.
Use of circular mechanical stapler appears to be a safe and effective technique at the jejunoesophageal anastomosis for total laryngopharyngeal defects with comparable fistula and stricture rates to grafts that are hand sewn.
本研究旨在展示在全喉咽切除重建中，使用圆形机械吻合器进行空肠转移吻合术的技术可行性和潜在优势，并比较吻合口瘘和狭窄的发生率。
本研究回顾性分析了 12 例使用圆形机械吻合器完成的空肠-食管吻合术，与 17 例手工缝合吻合术的空肠游离瓣进行比较。
共 29 例患者接受了空肠游离转移：12 例使用圆形机械吻合器进行空肠-食管吻合术，17 例患者进行手工吻合术。吻合口瘘和狭窄的发生率分别为吻合器组 0/12 例瘘和 3/12 例狭窄，手工组 2/17 例瘘和 0/17 例狭窄。两组之间瘘的发生率无统计学差异，而吻合器组狭窄的发生率有增加的趋势（p=0.06）。
在全喉咽缺损的空肠-食管吻合中，使用圆形机械吻合器似乎是一种安全有效的技术，其吻合口瘘和狭窄的发生率与手工缝合的移植物相当。
