Clinical efficacy of nested anastomosis assisted by tubular stapler in McKeown resection of esophageal cancer / 中华胸心血管外科杂志

ABSTRACT

Objective:To evaluate the clinical efficacy of traditional tubular mechanical anastomosis versus nested anastomosis assisted by tubular stapler in McKeown resection of esophageal cancer.Methods:A total of 182 patients who underwent McKeown resection for esophageal cancer between January 2016 and August 2017 were recruited, including 85 patients in the traditional tubular mechanical anastomosis group and 97 patients in the nested anastomosis assisted by tubular stapler group. The incidence of anastomotic fistula and anastomotic stenosis was observed in 6 months after the operation.Results:Compared with the traditional mechanical anastomosis, the incidence of anastomotic fistula in nested anastomosis assisted by tubular stape[0(0/97)vs. 4.7%(4/85)], lung infection[3.1%(3/97) vs. 11.8%(10/85)], gastroesophageal reflux[7.2%(7/97)vs. 17.6%(15/85)], anastomotic stenosis[3.1%(3/97) vs. 10.6%(9/85)], the neck incision infection rate[1.0%(1/97)vs. 7.1%(6/85), the operative anastomosis time[(14.69±2.65) min vs.(20.25±4.31)min], the difference was statistically significant( P<0.05). There was no significant difference in arrhythmia, recurrent laryngeal nerve injury, chylothorax and anastomosis between the two groups. Conclusion:The incidence of complications such as anastomotic fistula, anastomotic stricture, gastroesophageal reflux, and pulmonary infection can be significantly reduced by nested anastomosis assisted by tubular stapler, which is an ideal choice for cervical anastomosis in McKeown resection of esophageal cancer.