Effects Of Fusiform Tubular Stomach On Anastomotic Fistula Of Thoracic Esophageal Carcinoma

ObjectiveTo observe the effects of fusiform tubular stomach and thin tubular stomach on anastomotic fistula of thoracic esophageal carcinoma.Methods1.The clinical data of 225 patients with thoracic esophageal cancer in the First Affiliated Hospital of Zhengzhou University from February 2016 to October 2017 were collected and divided into two groups according to the way of making the tubular stomach(100 in the fusiform tubular stomach group and 125 in the thin tubular stomach group).The other operation methods and perioperative management were basically the same.The occurrence of anastomotic leakage was compared between the two groups.2.Check the general data of patients,compare and analyze the differences of the general data of age,gender,smoking,drinking,hypertension,diabetes,cerebrovascular disease,cardiovascular disease,chemotherapy,weight loss,total protein,albumin,prealbumin,FEV1,anastomotic mode,thoracic position,pathological stages of the two groups,and evaluate whether the data of the two groups are comparable.3.Take the general data of the above patients as covariates;take the two ways of making tubular stomach as dependent variables to do propensity score matching,and set the caliper value to 0.02;reevaluate the new results after matching.4.Spss24.0 statistical software was used to analyze.Mean ± SD was used for normal distribution measurement data,and t test was used for inter group comparison.The measurement data of skew distribution was expressed by M(QN),and the rank sum test was used for the comparison among groups.The counting data is expressed in absolute number or percentage,and the component comparison adopts ?2 test or Fisher exact probability method.The difference was statistically significant(P<0.05).Results:1.Before propensity score matching,225 patients with thoracic esophageal cancer underwent thoracoscopic laparoscopic radical resection of esophageal cancer,including 100 in the fusiform tube stomach group and 125 in the tubule stomach group.There was a difference in the baseline data of age,total protein,albumin,prealbumin and pathological stage between the two groups(P<0.05)(Table 1).There were 5 cases of anastomotic leakage in the fusiform tubular stomach group(5%)and 22 cases of anastomotic leakage in the tubule stomach group(17.6%),the difference was statistically significant(?2=8.35,P<0.05).There was no significant difference in bleeding,operation time,ICU transfer and anastomotic stenosis between the two groups(P>0.05)(Table 3).2.There were 44 pairs of patients matched successfully.After propensity score matching,the baseline data levels of the two groups were the same(P>0.05)(Table 2).There were 0 case of anastomotic leakage the fusiform tubular stomach group(0)and 6 cases of anastomotic leakage in the thin tubular stomach group(13.6%),the difference was statistically significant(P<0.05).There was no significant difference in bleeding,operation time,ICU transfer and anastomotic stenosis between the two groups(P>0.05)(Table 4).Conclusion:Compared with the thin tubular stomach,the fusiform tubular stomach can effectively reduce the incidence of anastomotic leakage in thoracic esophageal cancer.