ObjectiveTo compare medical cost and utilization efficiency of medical resources between manual layered anastomosis with mechanical stapling technique in esophagectomy. MethodsClinical data of 132 patients who underwent surgical resection of esophageal carcinoma in the Department of Thoracic Surgery of Gansu Tumor Hospital between January and October 2011 were respectively analyzed. According to different anastomotic techniques, all the patients were divided into a manual layered anastomosis group (including 40 males and 20 females with their age of 36-72 (49.3±7.6) years) and a mechanical stapling technique group (including 50 males and 22 females with their age of 30-79 (51.0±8.6) years). Demographic data, operation data, postoperative complications, direct and indirect medical cost, and constitution of direct medical cost were compared between the 2 groups. ResultsMedical cost of esophagectomy was 14 505.03± 1 523.37 yuan in the manual layered anastomosis group and 19 891.05±1 634.58 yuan in the mechanical stapling technique group respectively, which were statistically different (P < 0.05). Material cost was 2 242.00±751.08 yuan in the manual layered anastomosis group and 5 424.00±1 876.22 yuan in the mechanical stapling technique group respectively, which were statistically different (P < 0.05). Cost-effectiveness analysis showed that cost-effectiveness ratio in the manual layered anastomosis group was lower, thus this anastomotic technique was more reasonable. ConclusionMedical cost of manual layered anastomosis is lower than that of mechanical stapling technique in esophagectomy, as the utilization efficiency of medical resources of manual layered anastomosis is higher than that of mechanical stapling technique.
Objective To investigate the relative factors on tumor reocurrance or matastasis for over five years survival patients after esophageal carcinoma resection. Method We followed up the patients underwent esophageal carcinoma resection in our hospital and discharged between October 1997 and October 2002. We analyzed the clinical data of 181 over five years survival patients with complete follow-up data. There were 148 males and 33 females with the mean age of 63.9 years ranging from 60-70 years. We summarized the follow-up data and carried on the univariate analysis of relatively recurrent data. Result The result of univariate analysis showed that tumor recurrence as well as matastasis statistically related with degree of differentiation, pTNM stage, whether there was lymph node metastasis or not, and the number of lymph node metastasis (P<0.05), but not with gender, age, the length of tumor, the site of tunor, or other clinicopathologic characteristics (P>0.05). Conclusion The main factors influencing over five years survival rate after esophageal carcinoma resection are pTNM staging when operating, lymph node metastasis or not, and the number of lymph node metastasis.