ObjectiveTo explore the effects of modified telescopic embedding anastomosis in surgical treatment of esophageal and cardiac carcinoma. MethodsWe retrospectively analyzed the clinical data of 160 patients with esophageal or cardiac cancer undergoing surgery in our group from January 2014 through May 2015. There were 119 males and 41 females with a mean age of 61.6±7.1 years. Sixty-four patients received Sweet esophagectomy and 96 patients underwent minimally invasive Mckeown esophagectomy, and all the patients received end to side mechanical anastomosis. The patients were divided into a modified group and a traditional group according to the embedding types. There were 34 males and 12 females aged 61.7±6.4 years in the modified group undergoing modified telescopic embedding. There were 85 males and 29 females aged 62.2±7.5 years in the traditional group undergoing traditional interrupted horizontal mattress suture embedding. The anastomostic time and postoperative complications were compared between the two groups. ResultsCompared with the traditional group, obviously lower incidence of anastomotic fistula (0.0% vs. 12.3%, χ2=4.478, P=0.013), shorter anastomosis time (28.9±2.9 min vs. 30.0±3.1 min, t=-1.983, P=0.049), but a higher incidence of anastomotic stenosis (30.4% vs. 3.5%, χ2=23.799, P=0.000) in the modified group were found. There were no significant differences in the incidences of pulmonary complications, cardiovascular complications, laryngeal recurrent nerve injury, or perioperative mortality between the two groups (P>0.05). ConclusionModified telescopic embedding anastomosis is safe and feasible in surgical treatment of esophageal and cardiac carcinoma, and can effectively reduce the incidence of anastomotic fistula.
目的探讨单腔气管内插管保留自主呼吸的静脉全身麻醉下小儿胸腔镜手术的可行性及安全性。 方法选取郑州大学第一附属医院胸外科2012年2～12月采用单腔气管内插管保留自主呼吸行静脉全身麻醉下胸腔镜手术治疗的14例患儿作为试验组，男9例、女5例，年龄4～9岁；选取2010年5月至2011年10月采用常规双腔气管内插管全身麻醉下胸腔镜手术治疗的20例小儿患者作为对照组，男13例、女7例，年龄3～10岁。比较两组手术时间、术中失血量、术毕至拔管时间、住院费用、住院时间及术后并发症发生率等指标。 结果两组患儿手术均顺利，无术中术后死亡。试验组和对照组患儿平均手术时间[（85.7±16.9）min vs.（83.5±16.5）]及术中失血量[（90.0±55.0）ml vs.（85.0±50.0）ml]差异无统计学意义（P>0.05）。试验组的术毕至拔管时间[（0.5±0.1）min vs.（8.3±1.4）min]、住院费用[（24.3±4.7）千元vs.（27.8±5.3）千元]、住院时间[（6.6±0.9）d vs.（12.7±3.2）d]、术后并发症发生率（7.1%vs.25.0%）都显著短或少于对照组（P < 0.05）。 结论单腔气管内插管保留自主呼吸静脉全身麻醉下小儿胸腔镜手术治疗小儿胸部疾病具有一定的安全性及可行性。