食管癌术中器械吻合与手工分层吻合的安全性及治疗成本比较

目的比较食管癌（esophagus cancer，EC）术中器械吻合（MA）与手工分层吻合（LAH）的安全性及治疗成本。方法80例接受手术治疗的EC患者，术中分别接受LAH和MA各40例，比较两组术后并发症发生率、病死率、治疗费用及手术时间。结果LAH组吻合口狭窄和吻合口瘘发生率均低于MA组（P〈0．05），其他并发症发生率两组接近（P〉0．05）；MA组患者病死率高于LAH组（P〈0．05）；LAH组综合费用、手术材料费均低于MA组（P〈0．01），而两组术后住院费相接近（P〉0．05）；LAH组手术时间长于MA组（P〈0．05）。结论EC术中采用LAH虽然手术时间稍长，但其术后严重并发症及术后病死率较MA降低，综合费用、手术材料费也低于MA，因此，值得基层医院推广和应用。

The comparison of safety and therapeutic cost between mechanical anastomosis and layered anastomosis by hand in esophagus cancer operation

Objective To compare the safety and therapeutic cost between mechanical anastomosis （MA）and layered anastomosis by hand（LAH） in esophagus cancer（EC） operation. Methods Eighty patients with EC were divided into LAH group and MA group. The incidence of postoperative complications, mortality, treatment costs and operation time were compared between the two groups. Results The incidence of anastomotic stenosis in the LAH group was lower than that in the MA group（P 〈 0. 05）. The incidence of anastomotic fistula in the MA group was 8.0%, which was significantly higher than that in the LAH group（ P 〈 0. 05 ）. The incidence of other complications in the MA group was similar to that in the LAH groups. The postoperative mortality in the MA group was higher than that in the LAH group（ P 〈 0. 05 ）. The comprehensive cost and operation cost of raw materials in the LAH group were significantly lower than that in the MA group （P 〈 0. 01 ）. The postoperative hospitalization of the two groups was similar. The operation time in the LAH group was slightly longer than that in the MA group （ P 〈 0. 05 ）. Conclusion Although operation time of LAH in EC operation is longer,serious postoperative complications and postoperative mortality are significantly decreased when compared to MA. Moreover, comprehensive cost and operation cost of raw materials are relative low. Therefore,it is worthy of clinical application and pro- motion in primary hospitals.