Department of Surgery, VU University Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands.
Surg Endosc. 2012 Jul;26(7):1795-802. doi: 10.1007/s00464-012-2149-z. Epub 2012 Feb 1.
Minimally invasive Ivor Lewis esophagectomy is one of the approaches used worldwide for treating esophageal cancer. Optimization of this approach and especially identifying the ideal intrathoracic anastomosis technique is needed. To date, different types of anastomosis have been described. A literature search on the current techniques and approaches for intrathoracic anastomosis was held. The studies were evaluated on leakage and stenosis rate of the anastomosis.
The PubMed electronic database was used for comprehensive literature search by two independent reviewers.
Twelve studies were included in this review. The most frequent applied technique was the stapled anastomosis. Stapled anastomoses can be divided into a transthoracic or a transoral introduction. This stapled approach can be performed with a circular or linear stapler. The reported anastomotic leakage rate ranges from 0 to 10%. The reported anastomotic stenosis rate ranges from 0 to 27.5%.
This review has found no important differences between the two most frequently used stapled anastomoses: the transoral introduction of the anvil and the transthoracic. Clinical trials are needed to compare different methods to improve the quality of the intrathoracic anastomosis after esophagectomy.
微创 Ivor Lewis 食管切除术是全球范围内用于治疗食管癌的方法之一。需要优化这种方法，特别是确定理想的胸腔内吻合技术。迄今为止，已经描述了不同类型的吻合术。对胸腔内吻合术的当前技术和方法进行了文献检索。评估了研究吻合口漏和狭窄的发生率。
两位独立评审员使用 PubMed 电子数据库进行全面的文献检索。
本综述纳入了 12 项研究。最常应用的技术是吻合器吻合术。吻合器吻合术可分为经胸或经口引入。这种吻合器吻合术可以使用圆形或线性吻合器进行。报告的吻合口漏率为 0 至 10%。报告的吻合口狭窄率为 0 至 27.5%。
本综述发现最常使用的两种吻合器吻合术（经口引入套管和经胸）之间没有重要差异。需要临床试验来比较不同的方法，以提高食管癌手术后胸腔内吻合的质量。
