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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:

34

期数:

2017年2

页码:

157-159

栏目:

临床研究

出版日期:

2017-02-05

文章信息/Info

Title:

Value of gastric wall ligation in esophagogastrostomy with anastomat

作者:

杨增周; 王太增; 王献增

（林州市人民医院胸外科，河南　林州　456550）

Author(s):

YANG Zeng-zhou; WANG Tai-zeng; WANG Xian-zeng

（Department of Thoracic Surgery，the People′s Hospital of Linzhou City，Linzhou 456550，Henan Province，China)

关键词:

胃壁结扎; 食管胃吻合术; 吻合口狭窄; 吻合口瘘; 食管癌

Keywords:

gastric wall ligation; esophagogastrostomy; anastomotic stenosis; anastomotic fistula; esophageal carcinoma

分类号:

R735.1

DOI:

10.7683/xxyxyxb.2017.02.021

文献标志码:

A

摘要:

目的　探讨胃壁结扎在食管胃器械吻合术中的临床应用效果。方法　选取2015年2月至2016年3月在林州市人民医院行食管癌切除术的食管癌患者948例，根据术中食管胃吻合方式分为观察组（562例）和对照组（386例），对照组患者直接应用吻合器进行食管胃吻合，观察组患者先结扎吻合部胃壁再应用吻合器进行食管胃吻合。观察术后2组患者吻合口瘘发生率，并进行比较；2组患者术后3个月随访时进行胃镜检查，观察吻合口狭窄情况，并对2组患者吻合口狭窄发生率进行比较。结果　对照组患者发生吻合口瘘9例，吻合口瘘发生率为2.3%（9/386）；观察组患者发生吻合口瘘10例，吻合口瘘发生率为1.8%（10/562）；2组患者吻合口瘘发生率比较差异无统计学意义（χ²=0.36，P>0.05）。术后3个月，对照组患者进行胃镜检查348例，发生吻合口轻度狭窄6例，中度狭窄9例，重度狭窄17例，吻合口狭窄发生率为9.2%（32/348）；观察组患者进行胃镜检查514例，发生吻合口轻度狭窄15例，中度狭窄10例，重度狭窄5例，吻合口狭窄发生率为5.8%（30/514）；观察组患者吻合口狭窄发生率显著低于对照组（χ²=11.56，P<0.05）。结论　食管胃吻合前结扎吻合部胃壁可有效降低吻合口狭窄的发生率，但不能降低吻合口瘘的发生率。

Abstract:

Objective　To investigate the clinical effect of gastric wall ligation in esophagogastrostomy with anastomat.Methods　A total of 948 patients with esophageal carcinoma who underwent esophagectomy in the People′s Hospital of Linzhou City from February 2015 to March 2016 were selected.The patients were divided into observation group (n=562) and control group (n=386) according to the method of esophagogastrostomy.The patients in the control group were directly performed with esophagogastrostomy using anastomat，and the patients in the observation group were treated with esophagogastrostomy using anastomat after anastomotic gastric wall ligation.The incidence of postoperative anastomotic fistula was observed and compared between the two groups.The diameter of the anastomotic stoma was observed by gastroscopy three months after operation，and the incidence of anastomotic stenosis was compared between the two groups.Results　In the control group，anastomotic fistula occurred in 9 cases，and the incidence of anastomotic fistula was 2.3% (9/386).In the observation group，anastomotic fistula occurred in 10 cases，and the incidence of anastomotic fistula was 1.8%(10/562).There was no significant difference in the incidence of anastomotic fistula between the two groups(χ²=0.36，P>0.05).Three months after operation，348 patients in the control group were performed with gastroscopy，the incidence of anastomotic stenosis was 9.2% (32/348)，including mild stenosis in 6 cases，moderate stenosis in 9 cases and severe stenosis in 17 cases.A total of 514 patients in the observation group were performed with gastroscopy，the incidence of anastomotic stenosis was 5.8% (30/514)，including mild stenosis in 15 cases，moderate stenosis in 10 cases and severe stenosis in 5 cases.The incidence of anastomotic stenosis in the observation group was significantly lower than that in the control group(χ²=11.56，P<0.05).Conclusion　Gastric wall ligation before esophagogastrostomy can effectively reduce the incidence of anastomotic stenosis，but can not reduce the incidence of anastomotic fistula.

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更新日期/Last Update: 2017-02-05