机械吻合与手工吻合在食管外科中并发症的对比分析

目的　评价机械吻合在食管外科中的应用价值。方法　选择我院 1984～ 1994年间行食管癌、贲门癌切除术病例 ,比较机械吻合和手工吻合组术后与吻合技术相关的并发症的发生率。结果　机械吻合组平均手术时间、术后平均住院日均较手工组缩短 ;吻合口瘘、吻合口出血及死亡率 ,机械吻合组分别为 3.3%、0 .7%和 3% ;手工吻合组分别为 7.2 %、1.3%和 4.6 % ;轻、中、重度吻合口狭窄 ,机械吻合组分别为 2 .3%、2 .6 %和 0 .9% ,手工吻合组分别为 3%、4.5 %和 1.5 %。结论　机械吻合能有效降低术后并发症发生率 ,临床效果优于手工吻合。

The Comparative Study after Mechanical Suture and Hand Suture in Surgery of the Esophagus

Objective To evaluate the effect of mechanical suture in surgery of esophagus. Methods We have collected 573 cases of esophagogastrostomy and esophagojejunostomy with esophageal and cardial cancer in our hospital between April,1984 and April,1994(420 cases with the stapled technique and 153 cases with the hand technique).We compared the incidence of postoperative complications in the two groups. Results The median operating time by stapler was shorter than that with hand.The median hospitalized time after operation was decreased from 17 days to 13 days.The anastomotic leakage,anastomotic bleeding and mortality rate were 3.3%,0.7% and 3% in the group by stapler and 7.2% ,1.3% and 4.6% in other group.The rate of anastomotic stricture in slight,middle and strong degress were 2.3%,2.6% and 0.9% in the first group,and 3% ,4.5% and 1.5% in control group. Conclusion The clinical effect by stapler is better than that with hand.