Anti-fistula And Anti-reflux Function Of Telescopic Embedding Anastomosis In Surgical Treatment Of Adenocarcinoma Of The Esophagogastric Junction

Objective To explore the effect of preventing anastomotic fistula and anti-reflux of Telescopic Embedding Anastomosis in the Radical surgery of proximal gastric cancer for type Ⅱ and type Ⅲ adenocarcinoma of the esophagogastric junction,Discuss the clinical value of Telescopic Embedding Anastomosis.Method To select 74 cases of early type Ⅱ and type Ⅲ adenocarcinoma of the esophagogastric junction admitted to our hospital from November 2016 to November 2017,and divided randomly into experimental group(Telescopic Embedding Anastomosis group,44 cases)and control group(Traditional Embedding group,30 cases).Laparoscopic assisted proximal radical gastrectomy was performed in both groups.Using the same brand circular stapling device to anastomose the esophagogastric wall.Telescopic Embedding Anastomosis of experimental groups and Traditionally Embedding of control group.After the operation,one indwelling rubber drainage tube was placed on both left and right sides of the anastomosis.Lead out from the left and right sides of the rib.Daily oral administration of methylene blue on the 5th and 7th day after operation in both groups,to observe whether the bilateral drainage tube has blue dyeing,whenever there is one,it is considered as anastomotic leakage.After the patient is discharged,follow-up in three months,classified according to Visick,record reflux symptoms.According to the recorded data,conduct comparative analysis.Result There is no statistical difference(p>0.05)in general situation of two groups.Intraoperative situation : There are no statistical difference(p>0.05)in operation time(188.63±20.15 VS 185.77±16.20),anastomosis time(27.55±3.54 VS 26.40±2.59),intraoperative blood loss(119.77±38.50 VS 106.67±31.30).There is no statistical difference(p>0.05)in postoperative general complications,6 cases in the experimental group and 9 cases in the control group.Anastomotic fistula: There are statistical difference(p<0.05)in anastomotic fistula,0 cases in the experimental group and 6 cases in the control group.Gastroesophageal reflux: There are statistical difference(p<0.05)in anastomotic fistula,the number of cases in the test group I、II、III and IV was 30、10、3 and 1 respectively.The number of cases in the control group I、II、III and IV is 14、7、7 and 2.Anastomotic stricture:There are statistical difference(p<0.05)in anastomotic stricture,11 cases in the experimental group and 1 cases in the control group.Conclusion In the treatment of type II and type III esophageal gastric junctional adenocarcinoma undergoing radical gastrectomy for proximal gastrectomy,Telescopic Embedding Anastomosis has the effect of preventing anastomotic leakage and anti-reflux,However,high incidence of postoperative anastomotic stenosis.