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"胃食管吻合" 4 results
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目的 總結食管癌切除后采用消化道吻合器行頸部胃食管吻合術治療食管癌患者的臨床經驗，以降低術后吻合口瘺和吻合口狹窄的發生率，提高手術療效。 方法 125例食管癌患者，根據采用的手術術式不同分為兩組，器械吻合組：行食管癌切除后采用國產常州WGWB-26型吻合器進行頸部胃食管吻合；手工吻合組，行食管癌切除后采用手工方法進行頸部胃食管吻合。 比較兩種手術術式的胃食管吻合時間、術后吻合口瘺和吻合口狹窄的發生率。 結果 全組無手術死亡。器械吻合組吻合時間少于手工吻合組（30±5min vs. 55±5 min, Plt;0.05），近期吻合口瘺和吻合口狹窄發生率明顯低于手工吻合組（0% vs. 4.8%, 0% vs. 9.5%,Plt;0.05）；器械吻合組隨訪1～15個月食管X線鋇餐檢查證實無吻合口狹窄。 結論 使用吻合器行胃食管器械吻合，能增加吻合的可靠性，減少術后并發癥，包括吻合口瘺和吻合口狹窄的發生。
Release date：2016-08-30 06:08
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目的 為了減少食管、賁門癌切除、胃食管吻合術后吻合口瘺和吻合口狹窄的發生率,總結可吸收線胃食管分層連續縫合法的經驗. 方法 食管、賁門癌切除后,采用國產3-0帶針可吸收線在食管不同平面分層連續縫合行胃食管吻合術40例. 結果 全組無死亡,發生吻合口瘺1例,經治療痊愈;輕度吻合口狹窄3例,進軟食無梗阻,經行吻合口擴張后能正常進食. 結論 采用可吸收線分層連續縫合法行胃食管吻合術是可行的,吻合口瘺發生率低,吻合口狹窄發生少、程度輕.
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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目的 探討胃食管吻合術后胃食管反流癥狀的特征與相關因素的關系，以降低胃食管反流的發生率。 方法 回顧性分析239例食管、賁門癌切除胃食管吻合術后胃食管反流癥狀及與吻合平面、胃鏡下表現和吻合口狹窄的關系。 結果 108例出現胃食管反流癥狀，發生率45.2% (108/239) ，主動脈弓下胃食管反流癥狀的發生率大于主動脈弓上反流癥狀發生率(707% vs.318%, Plt;0.01). 影響生活的反流癥狀（≥6分）發生率為25.5%，主動脈弓下吻合反流癥狀程度較主動脈弓上吻合重（439% vs. 159%, Plt;0.01) 。胃鏡RE分級0+I級、II+III級出現反流癥狀的發生率分別為41.7%(63/151)和500% (44/88) ，兩者比較差異無統計學意義（χ2=1.541, P=0.214) ，反流癥狀的嚴重程度與RE分級無相關性（r=0080, P=0.276) 。在有癥狀的反流患者中吻合口狹窄發生率為37% (40/108) ，無癥狀的反流患者中未發現吻合口狹窄,兩者比較差異有統計學意義（χ2=49.262, P=0.000) 。吻合口狹窄與有胃食管反流癥狀呈正相關(r=0.480,P=0048). 結論 食管胃吻合術后只有部分患者出現反流癥狀，主動脈弓下吻合反流癥狀多于主動脈弓上吻合，且程度較重。反流癥狀的嚴重程度及發生率與RE分級無關。吻合口狹窄與胃食管反流相關。
Release date：2016-08-30 06:16
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