SDH型吻合器与传统手工行食管胃吻合的临床对照研究

目的 比较应用SDH型吻合器与手工行食管胃胸内吻合的近期临床效果。方法 总结1997年8月－2000年8月行食管癌和贲门癌切除、应用SDH型吻合器行食管胃（或食管空肠）胸内吻合468例的临床疗效，并与1994年8月－1997年7月临床资料相近的手工吻合435例进行回顾性对比分析。结果 吻合器吻合和手工吻合术后吻合口瘘发生率分别为0.2%（1／468）和3.0%(13/435)，有显著性差异（P＜0.05）；吻合口狭窄发生率分别为0.6%（3／468），4.8%（21／435），有显著性差异P＜0.05。手工吻合因吻合口瘘而死亡的占15.4%（2／13）。结论 应用吻合器和提高手术技巧，可使食管胃胸内吻合术后吻合口瘘及狭窄发生率降低至很低水平，吻合器吻合的光滑、柔软，患者进食早。

Clinical Study of Esophagogastro-anastomosis by SDH Anatomotic Apparatus

Objective To study the short term clinical result of esophagogastro anastomosis by novel SDH anatomotic apparatus.Methods A retrospective analysis was made between two groups:group 1 contained 468 cases of intrathoracic esophagogastro anastomosis by novel SDH anatomotic apparatus from Aug.1997 to Aug.2000;group 2 contained 435 cases of such procedure by handiwork from Aug.1994 to Aug.1997.Results The incidence of anastomotic leakage was 0.2%(1/468) in group 1,3.0%( 13/435 ) in group 2;while the incidence of anastomotic stoma stenosis were 0.6%(3/465),4.8%(21/435),respectively.Significant difference with ( P <0.05) was shown between thetwo groups.The mortality of leakage in group 2 was 15.4%(2/13).Conclusion Compared with traditional handiwork,use of SDH anastomotic apparatus in intrathoracic esophagogastro anastomosis decreases obviously the incidence of anastomotic leakage and anatomotic stoma stenosis with postoperative earlier food intake.