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目的 探讨食管癌术后吻合口瘘发生的原因 ,并分析手工吻合和器械吻合在食管癌切除术后食管胃吻合口瘘中的临床差异。方法 回顾分析 1994年 1月～ 2 0 0 1年 3月 5 89例食管癌根治性切除病例 ,并按手工吻合和器械吻合两种不同吻合方式分组比较。结果 5 89例病例中 ,手工吻合组术后发生吻合口瘘 15例 (6 .5 % ) ,器械吻合组术后发生吻合口瘘 2 3例 (6 .4 % ) ,发生率无显著性差异 (P >0 .0 5 )。但器械吻合组手术时间为 (14 5± 16 )分钟 ,手工吻合组为 (170± 2 2 )分钟 ,有极显著性差异 (P <0 .0 1)。吻合口瘘组血浆白蛋白为 (36 .9± 7.1) g/L ,无吻合口瘘组为 (38.7± 7.2 ) g/L ,两组比较无显著性差异 (P >0 .0 5 )。结论 器械吻合方便、快捷 ,明显地缩短了手术操作时间 ,但并未能降低吻合口瘘的发病率。
Objective To investigate the causes of anastomotic fistula after esophageal cancer surgery and to analyze the clinical difference between manual anastomosis and instrument anastomosis in esophagogastric anastomotic fistula after resection of esophageal cancer. Methods A retrospective analysis of 5 89 cases of esophageal cancer radical resection from January 1994 to March 2001 was performed and compared by manual anastomosis and instrument anastomosis in two different anastomosis groups. Results In 5 89 cases, anastomotic fistula occurred in 15 cases (6.5%) after manual anastomosis, and anastomotic fistula occurred in 23 cases (6.4%) in the anastomosis group, the incidence was not significantly different (P> 0.05). However, the operative time was (14 5 ± 16) minutes in the anastomosis group and 170 ± 22 minutes in the manual anastomosis group, with significant difference (P <0.01). The plasma albumin in the anastomotic fistula group was (36.9 ± 7.1) g / L, while the group without anastomotic fistula was (38.7 ± 7.2) g / L. There was no significant difference between the two groups (P> 0.05). Conclusions Device anastomosis is convenient, quick and obviously shortens the operation time, but it does not reduce the incidence of anastomotic fistula.