食管癌和贲门癌切除器械吻合1360例

目的评价食管癌和贲门癌切除器械吻合的效果。方法笔者1998-08～2006-03应用圆型吻合器对1 360倒食管、贲门癌切除后进行机械吻合。其中男760例,女600例。年龄16～88岁。食管癌800例,贲门癌560例。食管胃颈部吻合12例,胸顶吻合98例,弓上吻合620例,弓下吻合630例。结果术后出现吻合口瘘7例(0．5%),发生术后吻合口狭窄22例(1．6%),术中吻合出现器械故障20例(1．5%)。结论消化道圆型吻合器在上消化道重建手术中是安全可靠的,器械吻合是减少术后吻合口瘘的有效技术。

Application of stapling device in surgery for carcinoma of esophagus or cardia

Objective To evaluate the application of circular stapler in upper digestive tract reconstruction.Methods Retrospective review of 1 360 patients with carcinoma of esophagus or cardia undergoing a stapled esophagogastric anastomosis from August,1998 to March,2006 were conducted. Among 1 360 cases there were 760 males and 600 females with age ranged from 16 to 88 years. Carcinoma of esophagus was present in 800 patients and carcinoma of gastric cardia in 560 patients.The anastomosis was performed in the cervical region in 12 cases,thoracic apex in 98 cases,super aortic in 620 cases and inferior aortic in 630 cases.Results Anastomotic leakage occurred in 7 patients with an overall incidence of 0.5%,and benign anastomotic stricture was found in 22 patients with a rate of 1.6%. Instrumental failure occurred in 20 cases with a rate of 1.5%,as well.Conclusion Circular stapler can be used safely and reliably in upper digestive tract surgery,and the stapled anastomosis is a effective technique to reduce the incidence of anastomotic leakage.