Bardini R, Asolati M, Ruol A, Bonavina L, Baseggio S, Peracchia A
Department of Surgery, University of Padua, Policlinico Universitario, Italy.
World J Surg. 1994 May-Jun;18(3):373-8. doi: 10.1007/BF00316817.
Esophageal anastomosis is still associated with a high rate of complications even though they have decreased considerably in recent years. Anastomotic leaks are more frequent in the neck than in the chest, and related mortality rate is not different. The leakage incidence does not depend on suture materials or on technical modalities used to perform the anastomosis. In fact, there is no difference between the leakage rate when comparing manual and mechanical anastomoses. The leak incidence after both mechanical and manual anastomoses is much higher in collective reviews than in reports coming from leading centers. "Frequent" esophageal surgeons can learn from their previous experience and therefore avoid technical errors, whereas "causal" esophageal surgeons do not have this opportunity. Performing an esophageal anastomosis is a technical matter, and suture healing is independent of the patient's biologic situation. Anastomotic fibrotic strictures are frequent after both manual and mechanical anastomoses, and most can be avoided by meticulous suturing technique.
尽管近年来食管吻合术的并发症发生率已大幅下降，但仍与较高的并发症发生率相关。颈部吻合口漏比胸部更常见，且相关死亡率并无差异。漏出发生率并不取决于缝合材料或进行吻合术所采用的技术方式。事实上，比较手工吻合和机械吻合时，漏出率并无差异。在综合综述中，机械吻合和手工吻合后的漏出发生率均远高于顶尖中心的报告。“经验丰富”的食管外科医生能够从既往经验中学习，从而避免技术失误，而“经验不足”的食管外科医生则没有这样的机会。进行食管吻合术是一个技术问题，缝线愈合与患者的生物学状况无关。手工吻合和机械吻合后吻合口纤维化狭窄都很常见，大多数可通过精细的缝合技术避免。
