Application of Telescopic Embedding Anastomosis in Surgical Treatment of Esophageal and Cardiac Carcinoma: A Case Control Study_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

SONGShuai-lin , QIYu , YANGYang , LIUDong-lei , ZHANGChun-yang , WUKai ,  ZHAOSong

Department of Thoracic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, P. R. China;

Corresponding?author：

ZHAOSong, Email: zhaosong@zzu.edu.cn

Keywords：

Esophageal and cardiac carcinoma; Telescopic embedding anastomosis; Postoperative complications

DOI：

10.7507/1007-4848.20160233

Video：

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Objective To explore the effects of modified telescopic embedding anastomosis in surgical treatment of esophageal and cardiac carcinoma. Methods We 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. Results Compared 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). Conclusion Modified telescopic embedding anastomosis is safe and feasible in surgical treatment of esophageal and cardiac carcinoma, and can effectively reduce the incidence of anastomotic fistula.

Citation： SONG Shuai-lin, QI Yu, YANG Yang, LIU Dong-lei, ZHANG Chun-yang, WU Kai, ZHAO Song. Application of Telescopic Embedding Anastomosis in Surgical Treatment of Esophageal and Cardiac Carcinoma: A Case Control Study. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2016, 23(10): 974-977. doi: 10.7507/1007-4848.20160233 Copy

1.	毛友生, 赫捷, 高樹庚, 等. 我國食管癌外科治療目前存在的熱點爭議與未來研究方向. 中華胃腸外科雜志, 2015, 18(9): 851-854.
2.	孫超, 石維平, 束余聲, 等. 管狀胃在食管癌切除術頸部吻合中的應用. 中國胸心血管外科臨床雜志, 2012, 19(2): 148-150.
3.	王楓, 柳碩巖, 王健鍵, 等. 全腔鏡食管癌三野根治術頸部機械吻合與手工吻合的應用比較. 中華胃腸外科雜志, 2014, 17(9): 881-883.
4.	馬明全, 姜宏景, 唐鵬, 等. 胸腔鏡微創與開發食管癌根治術圍手術期并發癥和淋巴結清掃情況的回顧性比較. 中華胸心血管外科雜志, 2015, 31(5): 260-263.
5.	Luketich JD, Pennathur A, Awais O, et al. Outcomes after minimally invasive esophagectomy: review of over 1000 patients. Ann Surg, 2012, 256(1): 95-103.
6.	張霓, 徐沁孜, 蔡奕欣, 等. 全胸腔鏡食管癌外科治療的手術模式及其演變. 中華胸心血管外科雜志, 2013, 29(6): 323-325.
7.	范虹, 王群. 機器人外科手術系統在食管癌手術治療中的應用. 上海醫學, 2011, 34(1): 74-76.
8.	朱泳樵, 黃佳, 林皓, 等. 機器人輔助下胸腔鏡手術(RATS)與傳統胸腔鏡手術(VATS)術后患者疼痛情況的比較研究. 中國胸心血管外科臨床雜志, 2015, 22(12): 1095-1099.
9.	易俊, 熊磊, 李德閩, 等. 達芬奇機器人在食管癌外科治療中的應用. 中國胸心血管外科臨床雜志, 2015, 22(10):910-913.
10.	Biere SS, van Berge Henegouwen MI, Maas KW, et al. Minimally invasive versus open oesophagectomy for patients with oesophageal cancer: a multicentre, open-label, randomized controlled trial. Lancet, 2012, 379(9829): 1887-1892.
11.	譚黎杰, 馮明祥, 沈亞星, 等. 頸部三角吻合術在微創食管切除術中的應用. 中華胃腸外科雜志, 2014, 17(9): 869-871.
12.	師曉天, 許冰, 張新華, 等. 食管癌切除管狀胃重建術后吻合口瘺的預防策略. 中華胃腸外科雜志, 2014, 17(9): 941-942.
13.	周乃康, 梁朝陽, 柳曦, 等. 食管癌和賁門癌手術中應用圓形吻合器的經驗. 中華胃腸外科雜志, 2007, 23(4): 269-270.
14.	方文濤, 陳文虎, 范利民, 等. 食管癌切除術后不同重建途徑吻合口瘺的原因及預. 中華胃腸外科雜志, 2005, 8(3): 217-219.
15.	Amaris M, Dua KS, Naini SR, et al. Characterization of the upper esophageal sphincter response during cough. Chest, 2012, 142(5): 1229-1236.
16.	程載興, 李勁松, 王建軍, 等. 食管癌切除術后遲發型吻合口瘺的原因及診斷分析. 臨床外科雜志, 2014, 22(6): 458-459.
17.	邵令方, 王其彰. 新編食管外科學. 石家莊: 河北科學技術出版社, 2002. 659-660.
18.	Williams VA, Watson TJ, Zhovtis S, et al. Endoscopic and symptomatic assessment of anastomotic strictures following esophagectomy and cervical esophagogatrostomy. Surg Endosc, 2008, 22(6): 1470-1476.
19.	吳玥, 周雪, 陳瑤, 等. 內鏡下不同治療方案對食管吻合口狹窄的療效分析. 第三軍醫大學學報, 2014, 36(10): 1092-1097.

1. 毛友生, 赫捷, 高樹庚, 等. 我國食管癌外科治療目前存在的熱點爭議與未來研究方向. 中華胃腸外科雜志, 2015, 18(9): 851-854.
2. 孫超, 石維平, 束余聲, 等. 管狀胃在食管癌切除術頸部吻合中的應用. 中國胸心血管外科臨床雜志, 2012, 19(2): 148-150.
3. 王楓, 柳碩巖, 王健鍵, 等. 全腔鏡食管癌三野根治術頸部機械吻合與手工吻合的應用比較. 中華胃腸外科雜志, 2014, 17(9): 881-883.
4. 馬明全, 姜宏景, 唐鵬, 等. 胸腔鏡微創與開發食管癌根治術圍手術期并發癥和淋巴結清掃情況的回顧性比較. 中華胸心血管外科雜志, 2015, 31(5): 260-263.
5. Luketich JD, Pennathur A, Awais O, et al. Outcomes after minimally invasive esophagectomy: review of over 1000 patients. Ann Surg, 2012, 256(1): 95-103.
6. 張霓, 徐沁孜, 蔡奕欣, 等. 全胸腔鏡食管癌外科治療的手術模式及其演變. 中華胸心血管外科雜志, 2013, 29(6): 323-325.
7. 范虹, 王群. 機器人外科手術系統在食管癌手術治療中的應用. 上海醫學, 2011, 34(1): 74-76.
8. 朱泳樵, 黃佳, 林皓, 等. 機器人輔助下胸腔鏡手術(RATS)與傳統胸腔鏡手術(VATS)術后患者疼痛情況的比較研究. 中國胸心血管外科臨床雜志, 2015, 22(12): 1095-1099.
9. 易俊, 熊磊, 李德閩, 等. 達芬奇機器人在食管癌外科治療中的應用. 中國胸心血管外科臨床雜志, 2015, 22(10):910-913.
10. Biere SS, van Berge Henegouwen MI, Maas KW, et al. Minimally invasive versus open oesophagectomy for patients with oesophageal cancer: a multicentre, open-label, randomized controlled trial. Lancet, 2012, 379(9829): 1887-1892.
11. 譚黎杰, 馮明祥, 沈亞星, 等. 頸部三角吻合術在微創食管切除術中的應用. 中華胃腸外科雜志, 2014, 17(9): 869-871.
12. 師曉天, 許冰, 張新華, 等. 食管癌切除管狀胃重建術后吻合口瘺的預防策略. 中華胃腸外科雜志, 2014, 17(9): 941-942.
13. 周乃康, 梁朝陽, 柳曦, 等. 食管癌和賁門癌手術中應用圓形吻合器的經驗. 中華胃腸外科雜志, 2007, 23(4): 269-270.
14. 方文濤, 陳文虎, 范利民, 等. 食管癌切除術后不同重建途徑吻合口瘺的原因及預. 中華胃腸外科雜志, 2005, 8(3): 217-219.
15. Amaris M, Dua KS, Naini SR, et al. Characterization of the upper esophageal sphincter response during cough. Chest, 2012, 142(5): 1229-1236.
16. 程載興, 李勁松, 王建軍, 等. 食管癌切除術后遲發型吻合口瘺的原因及診斷分析. 臨床外科雜志, 2014, 22(6): 458-459.
17. 邵令方, 王其彰. 新編食管外科學. 石家莊: 河北科學技術出版社, 2002. 659-660.
18. Williams VA, Watson TJ, Zhovtis S, et al. Endoscopic and symptomatic assessment of anastomotic strictures following esophagectomy and cervical esophagogatrostomy. Surg Endosc, 2008, 22(6): 1470-1476.
19. 吳玥, 周雪, 陳瑤, 等. 內鏡下不同治療方案對食管吻合口狹窄的療效分析. 第三軍醫大學學報, 2014, 36(10): 1092-1097.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Application of Telescopic Embedding Anastomosis in Surgical Treatment of Esophageal and Cardiac Carcinoma: A Case Control Study

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