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"胃食管吻合" 4 results
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目的 总结食管癌切除后采用消化道吻合器行颈部胃食管吻合术治疗食管癌患者的临床经验，以降低术后吻合口瘘和吻合口狭窄的发生率，提高手术疗效。 方法 125例食管癌患者，根据采用的手术术式不同分为两组，器械吻合组：行食管癌切除后采用国产常州WGWB-26型吻合器进行颈部胃食管吻合；手工吻合组，行食管癌切除后采用手工方法进行颈部胃食管吻合。 比较两种手术术式的胃食管吻合时间、术后吻合口瘘和吻合口狭窄的发生率。 结果 全组无手术死亡。器械吻合组吻合时间少于手工吻合组（30±5min vs. 55±5 min, Plt;0.05），近期吻合口瘘和吻合口狭窄发生率明显低于手工吻合组（0% vs. 4.8%, 0% vs. 9.5%,Plt;0.05）；器械吻合组随访1～15个月食管X线钡餐检查证实无吻合口狭窄。 结论 使用吻合器行胃食管器械吻合，能增加吻合的可靠性，减少术后并发症，包括吻合口瘘和吻合口狭窄的发生。
Release date：2016-08-30 06:08
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目的 探讨胃食管吻合术后胃食管反流症状的特征与相关因素的关系，以降低胃食管反流的发生率。 方法 回顾性分析239例食管、贲门癌切除胃食管吻合术后胃食管反流症状及与吻合平面、胃镜下表现和吻合口狭窄的关系。 结果 108例出现胃食管反流症状，发生率45.2% (108/239) ，主动脉弓下胃食管反流症状的发生率大于主动脉弓上反流症状发生率(707% vs.318%, Plt;0.01). 影响生活的反流症状（≥6分）发生率为25.5%，主动脉弓下吻合反流症状程度较主动脉弓上吻合重（439% vs. 159%, Plt;0.01) 。胃镜RE分级0+I级、II+III级出现反流症状的发生率分别为41.7%(63/151)和500% (44/88) ，两者比较差异无统计学意义（χ2=1.541, P=0.214) ，反流症状的严重程度与RE分级无相关性（r=0080, P=0.276) 。在有症状的反流患者中吻合口狭窄发生率为37% (40/108) ，无症状的反流患者中未发现吻合口狭窄,两者比较差异有统计学意义（χ2=49.262, P=0.000) 。吻合口狭窄与有胃食管反流症状呈正相关(r=0.480,P=0048). 结论 食管胃吻合术后只有部分患者出现反流症状，主动脉弓下吻合反流症状多于主动脉弓上吻合，且程度较重。反流症状的严重程度及发生率与RE分级无关。吻合口狭窄与胃食管反流相关。
Release date：2016-08-30 06:16
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目的 为了减少食管、贲门癌切除、胃食管吻合术后吻合口瘘和吻合口狭窄的发生率,总结可吸收线胃食管分层连续缝合法的经验. 方法 食管、贲门癌切除后,采用国产3-0带针可吸收线在食管不同平面分层连续缝合行胃食管吻合术40例. 结果 全组无死亡,发生吻合口瘘1例,经治疗痊愈;轻度吻合口狭窄3例,进软食无梗阻,经行吻合口扩张后能正常进食. 结论 采用可吸收线分层连续缝合法行胃食管吻合术是可行的,吻合口瘘发生率低,吻合口狭窄发生少、程度轻.
Release date：2016-08-30 06:32
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Objective
To evaluate the effects of robot-assisted Ivor Lewis esophagectomy (RAILE) in surgical treatment of esophageal cancer.
Methods
We retrospectively analyzed the clinical data of 70 patients diagnosed with mid-lower esophageal cancer undergoing RAILE in the Department of Thoracic Surgery in Ruijin Hospital Affiliated to Shanghai Jiaotong University between May 2015 and April 2018. There were 54 males and 16 females at average age of 62.0±7.6 years. Forty patients underwent circular end-to-end stapled intrathoracic anastomosis and 30 had a double-layered, completely hand-sewn intrathoracic anastomosis.
Results
The mean operating time was 308.7±60.6 minutes. And blood loss was 190.0±95.1 ml. There were 2 patients who underwent conversion to thoracotomy. There was no in-hospital and 30-day mortality. Overall complications were observed in 24 patients (34.3%), of whom 6 patients (8.6%) had anastomotic leakage. The median length of hospitalization was 9.0 (interquartile range, IQR, 5.0) days. The mean tumor size was 3.2±1.5 cm, and R0 resection was achieved in all patients. The mean number of totally dissected lymph nodes was 19.3±8.7.
Conclusion
RAILE is safe and technically feasible with satisfactory perioperative outcomes.
Release date：2018-08-28 02:21
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