食道癌に対する胸腔内吻合法症例の検討

Abstract

Cervical anastomosis (CA) is a standard reconstruction surgery for esophageal cancer, but we have experienced some complications after this operation. Therefore we have utilized intrathoracic anastomosis (ITA) for esophageal cancer since July 1999. In this study, we evalute the usefulness of ITA. Subjects were 26 esophageal cancer patients who underwent esophagectomy followed by reconstruction with a gastric roll in the period from July 1999 to February 2001. They were consisted of 15 cases undergoing ITA and 11 cases of CA. The operation time in ITA, was significantly shorter than that in CA (p＜0.01). The rate of anastomotic leakage in ITA was 6.7%, significantly lower than that in CA (p＜0.001). Average interval to start of food intake after operation was 12.5 days in ITA ; this was significantly shorter than 27.5 days in CA (p＜0.01). Moreover, periods of hospital stay after operation were significantly shorter in ITA than in CA (p＜0.02). Our data suggest that ITA is minimally invasive and less prome to postoperative complication for esophageal cancer located in the middle and lower esophagus.