连续和间断缝合在腔镜食管癌管状胃制作的比较

doi:10.3969/j.issn.1005-6483.2020.10.014

摘要/Abstract

摘要： 目的探讨连续缝合用于腔镜食管癌管状胃在缩短手术时间、减少术后胸腔引流量等方面的优势，评价该缝合方法的安全性、有效性。
方法 2017年1月～2017年7月在我院接受腔镜治疗的食管癌病人70例，随机分成试验组和对照组，每组各35例。试验组采用普里灵连续缝合包埋胃切缘，对照组采用慕丝线间断缝合包埋胃切缘。比较两组临床效果及术后并发症。
结果 70例病人均顺利完成管状胃代食管手术。试验组和对照组管状胃制作时间分别为（9.17±1.51）分钟、（17.40±1.14）分钟，总手术时间分别为（162.60±8.61）分钟、（165.51±7.82）分钟，术后第1天胸腔引流量分别为（175.43±70.89）ml、（216.57±94.15）ml，两组比较差异有统计学意义（P＜0.05）。两组管状胃长度、管状胃宽度、术中失血量、术后第1天胃管引流量、术后胃液颜色变化时间、乳糜胸、声音嘶哑、肺部感染、吻合口瘘、术后住院时间等比较差异无统计学意义（P＞0.05）。
结论连续缝合用于术中管状胃的包埋可明显减少管状胃制作的时间，缩短整体手术时间，减少术后第一天胸腔引流量，安全可行。

关键词: 食管肿瘤, 缝合, 腔镜手术, 管状胃

Abstract: Objective To explore the advantages of continuous suture for gastric tube in endoscopic esophagectomy in shortening the operation time and reducing the postoperative drainage fluid，and to evaluate the effectiveness and safety of the suture method.
Methods 70 patients with endoscopic esophagectomy from January 2017 and July 2017 in our hospital for treatment were divided into two groups.35 patients with continuous suture for gastric tube were control group，thirty-five patients with interrupted suture for gastric tube were observation.The effect and postoperative complications were compared and analyzed between the two groups.
Results All of the patients were successfully operated.The time of making gastric tube in control group[(9.17±1.51)min] was reduced compared with the observation group[(17.40±1.14)min，P＜0.05].Meanwhile，the control group had an advantage over the observation group in the operative time[(162.60±8.61)min,(165.51±7.82)min，P＞0.05] and the postoperative drainage fluid[(175.43±70.89)ml，(216.57±94.15)ml，P＜0.05].However，there were no significant differences in length and width of the gastric tube，the intraoperative blood loss，gastric juice on the first postoperative day，gastric juice color change time on the postoperative，chylothorax，hoarseness，lung infection,anastomotic fistula and hospitalization time after surgery(P＞0.05).
Conclusion The application of continuous suture for endoscopic esophageal carcinoma of gastric tube can decrease the time of making tubular stomach and surgery，and the duration of thoracic on the first postoperative day.It is safe and feasible for suture of gastric tube.

Key words: esophageal carcinoma, suture, endoscopic surgery, tubular stomach

刘强林称意罗卫民徐利强郭家龙. 连续和间断缝合在腔镜食管癌管状胃制作的比较[J]. 临床外科杂志, 2020, 28(10): 943-946.

LIU Qiang, LIN Chengyi, LUOWeimin, et al.. Comparison of continuous and interrupted suture for gastric tube in endoscopic esophagectomy[J]. JOURNAL OF CLINICAL SURGERY, 2020, 28(10): 943-946.

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