Wang Feng, Liu Shuoyan, Wang Jianjian, Chen Xiaofeng, Zheng Qingfeng, Wang Zhen, Xu Jianjian, Chen Saiyun
Department of Thoracic Surgery, Fujian Provincial Tumor Hospital, Fuzhou 350014, China.
Zhonghua Wei Chang Wai Ke Za Zhi. 2014 Sep;17(9):881-3.
To compare the associated anastomotic complication of cervical esophagogastric anastomosis between stapled and hand-sewn anastomosis in minimally invasive esophagectomy(MIE).
Clinical data of 203 patients with esophageal cancer receiving combined thoracoscopic and laparoscopic esophagectomy with anastomosis in the neck in our hospital from January 2010 to November 2013 were retrospectively analyzed. All the patients were divided into stapled group(104 patients) and hand-sewn group(99 patients). The incidence of anastomotic leakage and anastomotic stricture between these two groups were compared.
There were no significant differences between two groups in gender, age, body mass index, total protein, albumin, and neoadjuvant chemotherapy(all P>0.05). There was no significant difference between the two groups in the incidence of anastomotic leakage [6/104(5.77%) vs. 3/99(3.03%), P>0.05], while the difference in the incidence of anastomotic stricture was significant [10/104(9.62%) vs. 2/99(2.02%), P<0.05]. The time of anastomosis, dieting and hospital stay was (15.5±5.0) min, (5.0±2.8) d and (18.3±5.9) d in stapled group, which was significantly shorter than (28.0±4.5) min, (5.9±1.2) d and (21.8±4.2) d in hand-sewn group(all P<0.05).
In the minimally invasive esophagectomy, stapled cervical esophagogastric anastomosis is simple and precise, but it is associated with increased risk of anastomotic stricture, therefore the type of anastomosis should be chosen based on the conditions of the patient.
比较微创食管切除术（MIE）中吻合器吻合与手工缝合的颈部食管胃吻合术相关吻合口并发症。
回顾性分析2010年1月至2013年11月在我院接受胸腔镜联合腹腔镜食管癌切除术并在颈部吻合的203例患者的临床资料。所有患者分为吻合器组（104例）和手工缝合组（99例）。比较两组间吻合口漏和吻合口狭窄的发生率。
两组在性别、年龄、体重指数、总蛋白、白蛋白和新辅助化疗方面均无显著差异（所有P>0.05）。两组间吻合口漏发生率无显著差异[6/104（5.77%）对3/99（3.03%），P>0.05]，而吻合口狭窄发生率差异有统计学意义[10/104（9.62%）对
2/99（2.02%），P<0.05]。吻合器组的吻合时间、开始进食时间和住院时间分别为（15.5±5.0）分钟、（5.0±2.8）天和（18.3±5.9）天，明显短于手工缝合组的（28.0±4.5）分钟、（5.9±1.2）天和（21.8±4.2）天（所有P<0.05）。
在微创食管切除术中，吻合器颈部食管胃吻合术操作简单、精确，但吻合口狭窄风险增加，因此应根据患者情况选择吻合方式。
