Tan Lijie, Feng Mingxiang, Shen Yaxing, Wang Hao, Li Jingpei, Xi Yong, Wang Qun
Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
Zhonghua Wei Chang Wai Ke Za Zhi. 2014 Sep;17(9):869-71.
To explore the safety and feasibility of cervical triangulating stapled anastomosis(TSA) for esophagogastric anastomosis(EGA) after minimally invasive esophagectomy (MIE).
Clinical data of 137 patients undergoing MIE for esophageal cancer(EC) in our department from January 2013 to March 2014 using end to side circular stapled anastomosis (CSA, 60 cases) or end-to-end triangulating stapled anastomosis (TSA, 77 cases) in the neck were retrospectively analyzed. The short-term outcomes between the two groups were evaluated and compared.
Cervical anastomotic leakage occurred in 3 patients(3.9%) of TSA group, but in six(10.0%) of CSA group (P=0.152). The incidence of anastomotic stenosis was 1.3%(1/77) and 15.0%(9/60) in TSA and CSA group respectively(P=0.002). The median hospital stay and perioperative mortality were not significantly different between the two groups as well as postoperative respiratory and cardiovascular complications.
TSA is a safely and effectively alternative method for EGA with lower incidence of postoperative gastrointestinal complications, especially in anastomotic stricture.
探讨在微创食管癌切除术后行食管胃吻合术时采用颈部三角形吻合器吻合术（TSA）的安全性和可行性。
回顾性分析2013年1月至2014年3月在我科接受微创食管癌切除术的137例患者的临床资料，其中60例行颈部端端圆形吻合器吻合术（CSA），77例行颈部端端三角形吻合器吻合术（TSA）。对两组的短期结局进行评估和比较。
TSA组有3例（3.9%）发生颈部吻合口漏，而CSA组有6例（10.0%）发生（P = 0.152）。TSA组和CSA组的吻合口狭窄发生率分别为1.3%（1/77）和15.0%（9/60）（P = 0.002）。两组的中位住院时间、围手术期死亡率以及术后呼吸和心血管并发症方面无显著差异。
TSA是食管胃吻合术的一种安全有效的替代方法，术后胃肠道并发症发生率较低，尤其是吻合口狭窄。
