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, 高树庚, 等. 我国食管癌外科治疗目前存在的热点争议与未来研究方向. 中华胃肠外科杂志, 2015, 18(9): 851-854.
2.	孙超, 石维平, 束余声, 等. 管状胃在食管癌切除术颈部吻合中的应用. 中国胸心血管外科临床杂志, 2012, 19(2): 148-150.
3.	王枫, 柳硕岩, 王健键, 等. 全腔镜食管癌三野根治术颈部机械吻合与手工吻合的应用比较. 中华胃肠外科杂志, 2014, 17(9): 881-883.
4.	马明全, 姜宏景, 唐鹏, 等. 胸腔镜微创与开发食管癌根治术围手术期并发症和淋巴结清扫情况的回顾性比较. 中华胸心血管外科杂志, 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.	张霓, 徐沁孜, 蔡奕欣, 等. 全胸腔镜食管癌外科治疗的手术模式及其演变. 中华胸心血管外科杂志, 2013, 29(6): 323-325.
7.	范虹, 王群. 机器人外科手术系统在食管癌手术治疗中的应用. 上海医学, 2011, 34(1): 74-76.
8.	朱泳樵, 黄佳, 林皓, 等. 机器人辅助下胸腔镜手术(RATS)与传统胸腔镜手术(VATS)术后患者疼痛情况的比较研究. 中国胸心血管外科临床杂志, 2015, 22(12): 1095-1099.
9.	易俊, 熊磊, 李德闽, 等. 达芬奇机器人在食管癌外科治疗中的应用. 中国胸心血管外科临床杂志, 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.	谭黎杰, 冯明祥, 沈亚星, 等. 颈部三角吻合术在微创食管切除术中的应用. 中华胃肠外科杂志, 2014, 17(9): 869-871.
12.	师晓天, 许冰, 张新华, 等. 食管癌切除管状胃重建术后吻合口瘘的预防策略. 中华胃肠外科杂志, 2014, 17(9): 941-942.
13.	周乃康, 梁朝阳, 柳曦, 等. 食管癌和贲门癌手术中应用圆形吻合器的经验. 中华胃肠外科杂志, 2007, 23(4): 269-270.
14.	方文涛, 陈文虎, 范利民, 等. 食管癌切除术后不同重建途径吻合口瘘的原因及预. 中华胃肠外科杂志, 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.	程载兴, 李劲松, 王建军, 等. 食管癌切除术后迟发型吻合口瘘的原因及诊断分析. 临床外科杂志, 2014, 22(6): 458-459.
17.	邵令方, 王其彰. 新编食管外科学. 石家庄: 河北科学技术出版社, 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.	吴玥, 周雪, 陈瑶, 等. 内镜下不同治疗方案对食管吻合口狭窄的疗效分析. 第三军医大学学报, 2014, 36(10): 1092-1097.

1. 毛友生, 赫捷, 高树庚, 等. 我国食管癌外科治疗目前存在的热点争议与未来研究方向. 中华胃肠外科杂志, 2015, 18(9): 851-854.
2. 孙超, 石维平, 束余声, 等. 管状胃在食管癌切除术颈部吻合中的应用. 中国胸心血管外科临床杂志, 2012, 19(2): 148-150.
3. 王枫, 柳硕岩, 王健键, 等. 全腔镜食管癌三野根治术颈部机械吻合与手工吻合的应用比较. 中华胃肠外科杂志, 2014, 17(9): 881-883.
4. 马明全, 姜宏景, 唐鹏, 等. 胸腔镜微创与开发食管癌根治术围手术期并发症和淋巴结清扫情况的回顾性比较. 中华胸心血管外科杂志, 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. 张霓, 徐沁孜, 蔡奕欣, 等. 全胸腔镜食管癌外科治疗的手术模式及其演变. 中华胸心血管外科杂志, 2013, 29(6): 323-325.
7. 范虹, 王群. 机器人外科手术系统在食管癌手术治疗中的应用. 上海医学, 2011, 34(1): 74-76.
8. 朱泳樵, 黄佳, 林皓, 等. 机器人辅助下胸腔镜手术(RATS)与传统胸腔镜手术(VATS)术后患者疼痛情况的比较研究. 中国胸心血管外科临床杂志, 2015, 22(12): 1095-1099.
9. 易俊, 熊磊, 李德闽, 等. 达芬奇机器人在食管癌外科治疗中的应用. 中国胸心血管外科临床杂志, 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. 谭黎杰, 冯明祥, 沈亚星, 等. 颈部三角吻合术在微创食管切除术中的应用. 中华胃肠外科杂志, 2014, 17(9): 869-871.
12. 师晓天, 许冰, 张新华, 等. 食管癌切除管状胃重建术后吻合口瘘的预防策略. 中华胃肠外科杂志, 2014, 17(9): 941-942.
13. 周乃康, 梁朝阳, 柳曦, 等. 食管癌和贲门癌手术中应用圆形吻合器的经验. 中华胃肠外科杂志, 2007, 23(4): 269-270.
14. 方文涛, 陈文虎, 范利民, 等. 食管癌切除术后不同重建途径吻合口瘘的原因及预. 中华胃肠外科杂志, 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. 程载兴, 李劲松, 王建军, 等. 食管癌切除术后迟发型吻合口瘘的原因及诊断分析. 临床外科杂志, 2014, 22(6): 458-459.
17. 邵令方, 王其彰. 新编食管外科学. 石家庄: 河北科学技术出版社, 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. 吴玥, 周雪, 陈瑶, 等. 内镜下不同治疗方案对食管吻合口狭窄的疗效分析. 第三军医大学学报, 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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