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

doi:10.3969/j.issn.1005-6483.2020.04.012

摘要/Abstract

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.

Key words: left neck, T-type full mechanical lateral anastomosis, esophageal cancer, circular tubular stapler

严会志张军林称意程栋梁郭家龙. 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[J]. 临床外科杂志, 2020, 28(4): 338-340.

YAN Huizhi, ZHANG Jun, LIN Chengyi, et al.. Effect of TSA anastomosis on operative complications in esophageal cancer surgery[J]. JOURNAL OF CLINICAL SURGERY, 2020, 28(4): 338-340.

参考文献

相关文章 15

[1]	徐延昭, 张缜, 郭强等. 早期肠内免疫营养在全腔镜食管癌根治术后老年病人中的应用[J]. 临床外科杂志, 2019, 27(9): 773-776.
[2]	王校媛, 张金峰, 杨英男等. 食管癌胸腹腔镜下胸内吻合的技术浅谈[J]. 临床外科杂志, 2019, 27(7): 549-552.
[3]	吴开明, 姚龙, 康宁宁等. 进展期食管癌微创治疗术后远期疗效及预后因素分析[J]. 临床外科杂志, 2019, 27(7): 558-561.
[4]	陈沛锐, 卿秋杉, 车国卫等. 术前胸中上段食管癌颈部淋巴结转移相关因素分析[J]. 临床外科杂志, 2019, 27(7): 566-569.
[5]	李晓, 蔡琳, 张勇等. 西北地区单中心汉族人群食管鳞癌病人基因分布状况研究[J]. 临床外科杂志, 2019, 27(7): 571-573.
[6]	李汉杰, 景瑞军, 陈鑫等. 血清长链非编码RNA ANRIL、基质金属蛋白酶2与血清淀粉样蛋白A在食管癌中的表达及临床意义[J]. 临床外科杂志, 2019, 27(7): 577-580.
[7]	王世平. 食管癌根治食管胃颈部吻合术后吻合口漏的危险因素分析[J]. 临床外科杂志, 2019, 27(7): 612-614.
[8]	关树斌, 谷志涛, 茅腾等. 胸腺肿瘤淋巴结转移研究进展[J]. 临床外科杂志, 2019, 27(7): 622-625.
[9]	郑浩, 张仁泉. 局部进展期食管癌新辅助治疗的研究现状[J]. 临床外科杂志, 2019, 27(7): 626-629.
[10]	汪林宝, 赵坚, 李小飞. 食管癌术后吻合口瘘的发生原因与治疗[J]. 临床外科杂志, 2019, 27(2): 152-154.
[11]	谢颂平康敢军张兴华江万里黄杰. 食管癌术后复发再次手术临床疗效分析[J]. 临床外科杂志, 2018, 26(9): 674-675.
[12]	方一凡耿庆. 食管癌根治术后乳糜性浆膜腔积液的研究进展[J]. 临床外科杂志, 2018, 26(9): 712-714.
[13]	彭银杰李印陈威鹏凃成志袁俊马海波秦建军. 老年cT1N0M0食管癌病人内镜和手术治疗预后分析：基于SEER数据库[J]. 临床外科杂志, 2018, 26(9): 651-656.
[14]	陈传贵段晓峰姜宏景. 达芬奇机器人手术系统辅助对比胸腹腔镜辅助食管癌根治术的研究进展[J]. 临床外科杂志, 2018, 26(9): 715-718.
[15]	柳硕岩. 食管癌淋巴结清扫的现状与趋势[J]. 临床外科杂志, 2018, 26(9): 644-646.

Metrics

Viewed

Full text

Abstract

Cited

Shared

Discussed