食管癌切除患者颈部不同吻合方式发生吻合口瘘影响因素分析

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Abstract Objective To explore the influencing factors of anastomotic leakage in different cervical anastomoses in patients with esophageal carcinoma after esophagectomy. Methods A total of 139 cases of patients receiving cervical anastomosis of esophageal carcinoma in Zigong Fourth People′s Hospital from January 2015 to December 2019 were selected retrospectively as research objects. According to different methods of anastomosis, they were divided into manual anastomosis group (61 cases) and mechanical anastomosis group (78 cases). The preoperative and perioperative data were analyzed to compare the incidence of anastomotic leakage between manual anastomosis and mechanical anastomosis. According to the postoperative anastomotic leakage or not, the patients were divided into anastomotic leakage group (18 cases) and non-anastomotic leakage group (121 cases). The risk factors for anastomotic leakage were investigated based on the clinical data. Results The results of univaritate of anastomotic leakage showed that the tumor location, methods of anastomosis, tumor stage, operation time and neoadjuvant chemororadiotherapy were closely associated with anastomotic leakage (P<0.05). Then the results of multivariate analysis showed that mechanical anastomosis (β=0.978, OR=20.322, 95%CI=1.343-201.434), operation time >300 min (β=2.877, OR=1.150, 95%CI=1.101-1.893) were independent risk factors for anastomotic leakage (P<0.05). Among 139 cases of patients, the leakage rate of mechanical anastomosis was 19.2%, which was higher than that in manual anastomosis (4.9%), the difference was statistically significant (P<0.05). In the mechanical anastomosis group, the leakage rate in tubular stomach was higher than the baseball bat-shaped stomach, the difference was statistically significant (P<0.05). Conclusion Operation time and methods of anastomosis are independent risk factors of anastomotic leak. Layered anastomosis could effectively reduce the incidence of anastomotic leakage. Baseball bat-shaped tubular stomach could effectively reduce the incidence of leakage in mechanical anastomosis. End-to-end layered manual anastomos is associated with a lower rate of anastomotic leakage and slight injury in stomach, which is worthy of clinical application.

Key words： Esophagectomy Cervical anastomosis Anastomotic leakage End-to-end layered anastomos

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	TANG Bo
	ZHAO Xia
	LIU Hongbing
	ZHANG Qingfeng
	LIU Kui
	ZHANG Hui

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TANG Bo,ZHAO Xia,LIU Hongbing, et al. Analysis of influencing factors of anastomotic leakage in different cervical anastomoses in patients with esophageal carcinoma after esophagectomy[J]. 中国当代医药, 2022, 29(21): 18-22.

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https://www.dangdaiyiyao.com/EN/ OR https://www.dangdaiyiyao.com/EN/Y2022/V29/I21/18

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