Department of Gastroenterological Surgery, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan.
Department of Esophageal and Gastroenterological Surgery, Juntendo University Hospital, Tokyo, Japan.
Esophagus. 2021 Jul;18(3):475-481. doi: 10.1007/s10388-021-00816-2. Epub 2021 Feb 1.
Anastomotic leakage and stenosis remain major problems after esophageal reconstruction. This study evaluated the clinical outcomes between the total eversion (TE) triangulating stapling technique (TST) and conventional (C) TST.
The study included 404 consecutive patients with esophageal cancer who underwent cervical esophagogastrostomy by TST between January 2013 and December 2018. The postoperative outcomes were compared between TE-TST and C-TST using propensity score-matched analysis.
Before matching, the cT stage and the cTNM stage were different between the groups. After matching, each group consisted of 128 patients. The patients' background characteristics were similar between the groups. Although the incidence of anastomotic leakage was similar between the groups (p = 0.216), anastomotic stricture occurred in 19 (14.8%) and 7 (5.5%) patients in the C-TST and the TE-TST groups, respectively (p = 0.021).
The incidence of anastomotic stenosis was significantly lower in the TE-TST group than in the C-TST group. TE-TST decreases the incidence of anastomotic stricture and can improve the quality of life in patients undergoing esophagectomy.
食管重建后吻合口漏和狭窄仍然是主要问题。本研究评估了全外翻（TE）三角钉合技术（TST）与传统（C）TST 之间的临床结果。
本研究纳入了 2013 年 1 月至 2018 年 12 月间接受 TST 行颈段食管胃吻合术的 404 例食管癌连续患者。采用倾向评分匹配分析比较 TE-TST 和 C-TST 的术后结果。
匹配前，两组的 cT 分期和 cTNM 分期不同。匹配后，每组各有 128 例患者。两组患者的背景特征相似。尽管两组吻合口漏的发生率相似（p=0.216），但 C-TST 组和 TE-TST 组的吻合口狭窄发生率分别为 19 例（14.8%）和 7 例（5.5%）（p=0.021）。
TE-TST 组吻合口狭窄的发生率明显低于 C-TST 组。TE-TST 可降低吻合口狭窄的发生率，并可提高接受食管癌切除术患者的生活质量。
