食管癌手术中采用左颈部T形全机械侧侧吻合术吻合对相关手术并发症的影响

摘要: 目的 探讨左颈部T形全机械侧侧吻合术(T-type full mechanical lateral anastomosis,TSA)在食管癌手术中的应用效果。 方法 2016年1月~2018年4月我院拟实施全腔镜食管癌根治术的病人108例,根据入院顺序分为试验组和对照组两组,每组各54例。 试验组采用TSA吻合术,对照组采用圆形管状吻合器端侧吻合。对比两组的手术吻合时间、术后住院时间、手术并发症、吻合口狭窄发生情况、吻合口面积。 结果 试验组手术吻合 时间为(17.4±2.1)分钟,对照组为(25.8±3.0)分钟,两组比较差异有统计学意义(P<0.05)。试验组和对照组术后住院时间分别为(13.8±2.0)天与(14.3±2.3)天,差异无统计学意义(P>0.05);试验组患者的手术并发症率为12.96%,低于对照组的37.04%,差异有统计学意义(P<0.05);术后6个月,试验组术后发生吻合口狭窄发生率1.85%,对照组为14.81%,差异有统计学意义(P<0.05);术后6个月,试验组吻合口面积为(2.17±0.30)cm2,对照组为(1.90±0.28)cm2,差异有统计学意义(P<0.05)。 结论 食管癌手术中采用TSA可有效缩短吻合术时间、减少手术后并发症,尤其是减少吻合口狭窄的发生。

关键词: 左颈部, T形全机械侧侧吻合术, 食管癌, 圆形管状吻合器

Abstract: Objective To explore the effect of T-type full-mechanical lateral anastomosis(TSA)in the treatment of esophageal cancer. Methods 108 patients who underwent radical laparoscopic radical esophagectomy in our hospital from January 2016 to April 2018,were enrolled according to the order of admission.The patients were divided into the experimental group(with TSA anastomosis during surgery)and the control group(rounded during surgery).The end-to-side anastomosis of the tubular anastomosis was performed in 54 cases.The surgical anastomosis time,postoperative hospital stay,surgical complications,anastomotic stenosis,and anastomotic area were compared between the two groups. Results The anastomosis time(17.4±2.1)min in the test group was significantly lower than that in the control group(25.8±3.0)min(P<0.05).There was no significant difference in the postoperative hospital stay(13.8±2.0)days in the test group and(14.3±2.3)days in the control group(P>0.05).The surgical complication rate of patients in the test group was 12.96% lower than that in the control group(37.04%)(P<0.05);At 6 months after surgery,the incidence of anastomotic stenosis in the experimental group was 1.85% lower than that in the control group 14.81%,and the difference was statistically significant(P<0.05);At 6 months after operation,the anastomosis area(2.17±0.30)cm2 in the test group was higher than that in the control group(1.90±0.28)cm2,and the difference was statistically significant(P<0.05). Conclusion The use of left-neck T-type full-mechanical lateral anastomosis in esophageal cancer surgery can effectively shorten the time of anastomosis,reduce postoperative complications,and especially reduce the occurrence of anastomotic stenosis.

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