管状吻合器在食管外科中的应用

目的：对1200例食管癌、贲门癌、食管良性病变切除后应用管状吻合器的手术效果进行分忻。方法：食管胃颈部吻合4例，胸内吻合1116例。结果：术后发生吻合口瘘11例(0．91％)，颈部及超胸顶吻合无吻合口瘘发生。前8年胸内吻合口瘘发生率为2．32％、吻合口狭窄3．1％；近12年胸内吻合口瘘发生率为0．33％，吻合口狭窄占1％；进口吻合器吻合口瘘发生率为0．86％，吻合口狭窄6．9％。所有吻合口狭窄经扩张均恢复正常饮食。结论：机械吻合是减少胸内吻合口瘘的有效方法之一。

Effects of Stapled Anastomosis in Surgery of the Esophagus

Objective To analyse the effects of stapling anastomosis in the resectional treatment on esophageal cancer, cardial cancer and the benign esophageal diseases in 1200 patients. Methods The anastomosis was performed in the cervical region in 4 cases and intrathoracically in 1116. Results Anastomotic leakage occurred in 11 patients with an overall incidence of 0. 91% , There were no anastomot-ic leakage in the cervical anastomosis. The incidence of anastomotic leakage in the intrathoracic anastomosis was as high as 2. 32% and anastomtic stricture was 3. 1% between 1980 and 1988 but it decreased to 0. 33% from 1988 to 2000. Anastomotic stricture occurred in 1% , the anastomotic leakage incidence of import stapling was 0.86%, the anastomosis stricture was 6.9% and recovered after dilatation. Conclusion The clinicalexperience indicates that stapling anastomosis with a stapling device is a very effective procedure in reducing the incidence of esophageal anastomotic leakage especially in the intrathoracic anastomosis.