Comparison between layered anastomosis and mechanical anastomosis of tubular stomach and cervical esophagus in esophagectomy_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

 LI Junyan , WANG Yong , LIU Weiliang , XU Jianhua , LI Huajun

Department of Cardiothoracic Surgery, 3201 Hospital, Xi'an Jiaotong University, Hanzhong, Shanxi 723000, P.R.China;

Corresponding author：

LI Junyan, Email: lijunyan_2004@163.com

Keywords：

Tubular stomach; layered anastomosis; esophageal cancer; esophagectomy

DOI：

10.7507/1007-4848.201604006

Video：

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Objective To compare the outcome of tubular stomach and cervical esophagus laminated anastomosis and mechanical anastomosis. Methods A total of 128 patients with middle and upper esophageal cancer in our hospital from January 2013 to January 2016 were randomly divided into two groups, 64 patients in each group and all patients underwent esophagectomy. In the group A, there were 46 males and 18 females with age of 40–75 years, treated with tubular stomach and cervical esophagus layered anastomosis. There were 51 males and 13 females with age of 43–71 years in the group B receiving mechanical anastomosis. We observed the short-term and long-term efficacy as well as complications. Results In the group A, there was cervical anastomotic fistula in 1 patient, anastomotic stenosis in 2 patients and reflux esophagitis in 12 patients. In the group B, 1 patient suffered chylothorax, 8 patients cervical anastomotic fistula, 4 patients anastomotic stenosis and 14 patients reflux esophagitis. Conclusion Layered anastomosis can effectively reduce the incidence of anastomotic fistula and stenosis. Tubular stomach can effectively prevent and reduce the reflux esophagitis, and the high long-term quality of life will be achieved after the operation.

Citation： LIJunyan, WANGYong, LIUWeiliang, XUJianhua, LIHuajun. Comparison between layered anastomosis and mechanical anastomosis of tubular stomach and cervical esophagus in esophagectomy. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2017, 24(1): 61-64. doi: 10.7507/1007-4848.201604006 Copy

1.	杨列, 郑轶峰, 姜建青, 等. 不同食管胃吻合方式对术后并发症影响的 Meta 分析. 循证医学, 2013, 13(3): 173-180.
2.	Stein HJ, Sendler A, Fink U, et al. Multidisciplinary approach to esophageal and gastric cancer. Surg Clin North Am, 2000, 80(2): 659-682.
3.	龚太乾, 蒋耀光, 王如文, 等. 食管癌术后早期并发症及死亡原因分析. 中国胸心血管外科临床杂志, 2005, 12(3): 173-176.
4.	刘奎, 魏煜程. 食管吻合口瘘诊疗进展. 医学综述, 2012, 18(8): 1191-1104.
5.	Hu Z, Yin R, Fan X , et al. Treatment of intrathoracic anastomotic leak by nose fistula tube drainage after esophagectomy for cancer. Dis Esophagus, 2011, 24(2): 100-107.
6.	Kim RH, Takabe K. Methods of esophagogastric anastomoses following esophagectomy for cancer: a systematic review. J Surg Oncol, 2010, 101(6): 527-533.
7.	田烨, 周凌霄, 任光国. 1208 例食管癌患者术后吻合瘘风险因素分析. 重庆医学, 2014, 43(15): 1924-1926.
8.	杨光明, 孟镔, 张智, 等. 食管癌术后吻合口瘘防治的临床分析. 局解手术学杂志, 2009, 18(3): 185.
9.	张志庸, 李单青, 崔玉荷, 等. 食管贲门癌切除器械吻合术 519 例. 中国胸心血管外科临床杂志, 2001, 8(3): 197-198.
10.	Takala H, Saarnio J, Wiik H, et al. HIF-Iα and VEGF are associated with disease progression in esophageal carcinoma. Surg Res, 2011, 167(1): 41-48.
11.	陈传波, 路雪芹, 郑兰东, 等. 食管胃黏膜延长分层吻合的实验研究. 中国胸心血管外科临床杂志, 2002, 9(3): 201-204.
12.	Parekh K, Iannettoni MD. Complications of esophageal resection and reconstruction. Semin Thorac Cardiovasc Surg, 2007,19(1): 79-88.
13.	解晨浩, 赵雍凡, 寇瑛俐, 等. 食管胃分层吻合法吻合口愈合质量的实验研究. 中华胸心血管外科杂志, 2004, 20(5): 261-263.
14.	赵雍凡, 解晨昊, 王允, 等. 食管胃分层吻合法的应用与实验观察. 中国胸心血管外科临床杂志, 2005,12(3): 164-168.
15.	Jemal A, Bray F, Center MM, et al. Global cancer statistic. CA Cancer J Clin, 2011, 61(2): 69-90.
16.	Yamamoto S, Makuuchi H, Shimada H, et al. Clinical analysis of reflux esophagitis following esophagectomy with gastric tube reconstruction. J Gastroenterol, 2007, 42(5): 342-345.
17.	张思维, 张敏, 李光琳, 等. 2003～2007 年中国食管癌发病与死亡分析. 中国肿瘤, 2012, 21(4): 241-247.
18.	Pech O, Günter E, Dusemund F, et al. Accuracy of endoscopic ultrasound in preoperative staging of esophageal cancer: results from a referral center for early esophageal cancer. Endoscopy, 2010, 42(6): 456-461.
19.	Kim HK, Choi YH, Shim JH, et al. Endoscopic evaluation of the quality of the anastomosis after esophagectomy with gastric tube reconstruction. World J Surg, 2008, 32(9): 2010-2014.
20.	Heitmiller RF. Impact of gastric tube diameter on upper mediastinal anatomy after transhiatal esophagectomy. Dis Esophagus, 2000,13(4): 288-292.

1. 杨列, 郑轶峰, 姜建青, 等. 不同食管胃吻合方式对术后并发症影响的 Meta 分析. 循证医学, 2013, 13(3): 173-180.
2. Stein HJ, Sendler A, Fink U, et al. Multidisciplinary approach to esophageal and gastric cancer. Surg Clin North Am, 2000, 80(2): 659-682.
3. 龚太乾, 蒋耀光, 王如文, 等. 食管癌术后早期并发症及死亡原因分析. 中国胸心血管外科临床杂志, 2005, 12(3): 173-176.
4. 刘奎, 魏煜程. 食管吻合口瘘诊疗进展. 医学综述, 2012, 18(8): 1191-1104.
5. Hu Z, Yin R, Fan X , et al. Treatment of intrathoracic anastomotic leak by nose fistula tube drainage after esophagectomy for cancer. Dis Esophagus, 2011, 24(2): 100-107.
6. Kim RH, Takabe K. Methods of esophagogastric anastomoses following esophagectomy for cancer: a systematic review. J Surg Oncol, 2010, 101(6): 527-533.
7. 田烨, 周凌霄, 任光国. 1208 例食管癌患者术后吻合瘘风险因素分析. 重庆医学, 2014, 43(15): 1924-1926.
8. 杨光明, 孟镔, 张智, 等. 食管癌术后吻合口瘘防治的临床分析. 局解手术学杂志, 2009, 18(3): 185.
9. 张志庸, 李单青, 崔玉荷, 等. 食管贲门癌切除器械吻合术 519 例. 中国胸心血管外科临床杂志, 2001, 8(3): 197-198.
10. Takala H, Saarnio J, Wiik H, et al. HIF-Iα and VEGF are associated with disease progression in esophageal carcinoma. Surg Res, 2011, 167(1): 41-48.
11. 陈传波, 路雪芹, 郑兰东, 等. 食管胃黏膜延长分层吻合的实验研究. 中国胸心血管外科临床杂志, 2002, 9(3): 201-204.
12. Parekh K, Iannettoni MD. Complications of esophageal resection and reconstruction. Semin Thorac Cardiovasc Surg, 2007,19(1): 79-88.
13. 解晨浩, 赵雍凡, 寇瑛俐, 等. 食管胃分层吻合法吻合口愈合质量的实验研究. 中华胸心血管外科杂志, 2004, 20(5): 261-263.
14. 赵雍凡, 解晨昊, 王允, 等. 食管胃分层吻合法的应用与实验观察. 中国胸心血管外科临床杂志, 2005,12(3): 164-168.
15. Jemal A, Bray F, Center MM, et al. Global cancer statistic. CA Cancer J Clin, 2011, 61(2): 69-90.
16. Yamamoto S, Makuuchi H, Shimada H, et al. Clinical analysis of reflux esophagitis following esophagectomy with gastric tube reconstruction. J Gastroenterol, 2007, 42(5): 342-345.
17. 张思维, 张敏, 李光琳, 等. 2003～2007 年中国食管癌发病与死亡分析. 中国肿瘤, 2012, 21(4): 241-247.
18. Pech O, Günter E, Dusemund F, et al. Accuracy of endoscopic ultrasound in preoperative staging of esophageal cancer: results from a referral center for early esophageal cancer. Endoscopy, 2010, 42(6): 456-461.
19. Kim HK, Choi YH, Shim JH, et al. Endoscopic evaluation of the quality of the anastomosis after esophagectomy with gastric tube reconstruction. World J Surg, 2008, 32(9): 2010-2014.
20. Heitmiller RF. Impact of gastric tube diameter on upper mediastinal anatomy after transhiatal esophagectomy. Dis Esophagus, 2000,13(4): 288-292.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Comparison between layered anastomosis and mechanical anastomosis of tubular stomach and cervical esophagus in esophagectomy

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