Comparison Of Incidence Rate Of Anastomotic Stricture Between Conventional Anastomosis And Double-layers Anastomosis During Stapling Anastomosis After The Operation Of Esophageal Cancer

Background Digestive tract reconstruction is an important part of surgical treatment of esophageal cancer,intrathoracic operation of manual match complex procedure,tissue damage of interrupted suture,long operation time,the actual anastomosis operation is closely related to the surgical doctor proficiency,high incidence of anastomotic leakage,stenosis,anastomotic stricture,gastrointestinal bleeding,anastomotic inflammation after radical resection,increase the risk of patients.With the development of economic society and the establishment of the modern life concept,stapled match has become the most common way of anastomosis in major hospital,significantly reduce the incidence of anastomotic leakage,and anastomotic stricture is becoming the important subject in the thoracic surgery doctors attention after esophagectomy,literature reported incidence of 1.8 to 40%.The patients with dysphagia,eating symptoms tend to be similar to the preoperative status,reduce the patient’s disease resistance,severe stenosis patients even repeatedly expansion under gastroscope,increase the psychological and economic burden on patients,reduce the quality of life.Objective To explore how to decrease anastomotic stricture after the operation of esophageal cancer by improving anastomosis.Methods Clinical date of 374 cases with carcinoma aged > 60 years who had undergone left thoracotomy radical resection of esophagus cancer at our hospital from April 2013 to August 2015 were collected.Patients were divided into double-layers anastomosis group(n=187)and conventional anastomosis group(n=187).During process of stapling anastomosis,double purse string anastomosis on esophagus and gastric wall were performed in double-layers anastomotic,with no purse string suture in conventional anastomosis groups.Incidence rate of anastomosis stricture was compared between the two groups.Results Conventional anastomosis group versus double-layers anastomosis group showed that a mild anastomotic stricture occurred in 17 cases versus 7cases(χ2=4.452,P=0.035),a moderate anastomotic stricture in 12 cases vs.4 cases(χ2=3.199,P=0.074),a severe anastomotic stricture in 9 cases vs.3 cases(χ2=2.152,P=0.142),total number of anastomotic stricture in 38 cases vs.14 cases(χ2=12.866,P=0.000),showing that double-layers anastomosis was relatively superior to conventional anastomosis.Conclusion Double-layers anastomosis can effectively reduce the incidence of anastomotic stricture.