Efficacy And Safety Of Cervical Anastomotic Muscle Flap Embedding In Reducing Postoperative Cervical Anastomotic Mediastinal Fistula In Patients With Esophageal Cancer

Objective:To fully explore the effectiveness and safety of cervical anastomotic muscle flap embedded in reducing anastomotic thoracic fistula after cervical anastomotic mediastinal fistula after esophageal cancer,and to provide data support for reducing the incidence of anastomotic thoracic fistula after esophageal cancer.Materials and Methods:A total of 131 patients who received three-incision radical resection of esophageal cancer in our hospital from June 2017 to January 2021 were fully selected as the research subjects.Experimental group(n=49)received cervical anastomotic muscle flap embedding intraoperatively;Control group(n=82)did not receive cervical anastomotic muscle flap embedding;The general information,occurrence of postoperative anastomotic fistula,anastomotic thoracic fistula,dysphagia,pulmonary infection,postoperative sputum aspiration and frequency,ICU treatment,hoarseness,postoperative hospital stay and other items in the two groups were counted.Results:Basic features: There was no statistically significant difference between the control group and the experimental group in the clinical basic features of esophageal cancer patients(P>0.05).Duration of hospitalization: The total length of hospitalization and postoperative length of hospitalization in the experimental group were lower than those in the control group,with P values of 0.030 and 0.019,respectively,and the difference was statistically significant.Postoperative anastomotic mediastinal fistula: there was no mediastinal fistula in the experimental group,which was lower than the incidence of mediastinal fistula in the control group,P=0.008,and the difference was statistically significant.There was no significant difference in the incidence of anastomotic fistula and postoperative dysphagia between the two groups(P>0.05).Postoperative sputum aspiration and number of sputum aspiration by fiberbronchoscope between the two groups: P=0.744,there was no statistical significance(P > 0.05).Postoperative sputum aspiration times: Comparison between the two groups,P=0.199,the difference was not statistically significant;Pulmonary infection in the experimental group was lower than that in the control group,P=0.018,and the difference was statistically significant.Percentage of postoperative admission to ICU: Comparison between the two groups showed that P=0.140,the difference was not statistically significant.Item analysis of postoperative hoarseness: the proportion of the experimental group and the control group was the same,P=0.095,the difference was not statistically significant.Conclusions:It is an effective and safe method to reduce the harm of anastomotic fistula after three-incision radical resection of esophageal cancer,which is worthy of further promotion in clinical practice.