International Journal of Surgical Research. 2018; 1: (2) 2; DOI:10.26855/j.ijsr.20180003.
目的：本文探究 胸中下段食管癌手术中应用器械吻合的安全性及临床疗。方法：将2004年1月至2015年12月来本院初诊为胸中下段食管癌的70例患者随机分为对照组和观察组2组。对照组术中采用手工吻合技术处理手术残端，观察组则应用器械吻合技术处理残端。观察并记录两组患者的手术效果、术后并发症发生率及对症处理效果。术后随访5年，观察并对比分析两组患者的5年生存率。结果：治疗前，两组患者的一般情况无显著差异，具有可比性 （P>0.05）。观察组患者的手术总时间、吻合时间、术中出血量、总住院时间以及住院总费用等手术一般情况均显著低于同期的对照组，且组间对比差异显著（P<0.05）；观察组的手术总有效率高达94.29%，显著高于同期对照组的74.29%，组间数据对比具有统计学意义（P<0.05）；术后随访后发现，观察组患者术后并发症发生率显著低于同期的对照组（P<0.05）；观察组患者的5年生存率曲线较对照组的生存率曲线平缓，总体生存情况优于同期对照组。结论：应用器械吻合技术处理胸中下段食管癌患者手术残端具有良好的临床效果，其较人工吻合技术操作便捷，具有较佳的手术效果及较少的术后并发症，值得在临床上推广。
Objective: To explore the effect of the application of Apparatus anastomosis in the patients with Middle-Lower thoracic esophageal carcinoma. Methods: 70 patients with middle-lower thoracic esophageal carcinoma receiving treatment in our hospital from January 2004 to December 2015 were selected as the clinical research objects. According to the treatment plan, the patients were randomly divided into control group and observation group. Patients who were in the observation group were applied apparatus anastomosis to dispose the operating stump of esophageal carcinoma，while patients that in the control group were adopted manual anastomosis to dispose it. To observe the clinical effects, the symptomatic treatment effect and the adverse reactions in patients with the occurrence, after the end of treatment of two groups of patients to judge the curative effect. Two groups of patients all need to have the postoperative follow-up visits for 5 years and their survival rate in both groups were compared. Results: There was no significant difference in the normal information of the two groups before the treatment (P>0.05). After treatment, we compared the general situation of operation in two groups, we got to know that the total operating time, surgical anastomosis time, the amount of bleeding, the time of hospitalization and the cost of hospitalization in the observation group were significantly lower than those of the control group, with P<0.05, with statistical difference. The total success rate of patients in the observation group were 94.29%. And this rate in the control group was only 74,29%, which was significantly lower than those of the observation group, with P<0.05, which was of statistic value. Follow-up visits after surgery, the occurrence of postoperative complications in the observation was obviously lower than that of the control group (P<0.05). Five-year follow-up visits after surgery, the patients in observation group always had higher survival rates than patients in control group. And its curve fell more slowly than that of control group, which meant that the overall survival situation in the observation group is better than that in the same period of the control group. Conclusion : The application of apparatus anastomosis not only gains a definite effect on disposing the operating stump of esophageal carcinoma, but also reduces the complication after surgery and improved the prognosis of patients with quality of life，which can be worth to be widely applied clinically.