Comparative Study of End-to-side Stratified Anastomosis and End-to-side Stratified Anastomosis in Thoracic Laparoscopy Combined with Radical Resection of Esophageal Cancer

Sun Fan; Wang Yang; Zhang Ru

doi:10.3969/j.issn.1004-5775.2025.12.003

Abstract：Objective:To compare the efficacy and safety of end-to-side stratified anastomosis and end-to-side stratified anastomosis in thoracic laparoscopy combined with radical resection of esophageal cancer.Methods:A total of 128 patients with esophageal cancer who underwent thoracic laparoscopy combined with radical resection of esophageal cancer in the hospital from March 2021 to March 2023 were selected and divided into observation group(64 cases)and control group(64 cases)according to different anastomosis methods.End-to-side stratified anastomosis was selected for the observation group,and end-to-side stratified anastomosis was selected for the control group.The perioperative indexes(intraoperative blood loss,anastomotic time,total operation time and total hospital stay),the incidence of anastomotic complications(anastomotic stenosis,anastomotic fistula and gastroesophageal reflux),the incidence of surgical complications(pulmonary complications,arrhythmia,incision infection and transient hoarseness)and the changes of quality of life before and after surgery were compared between the two groups.Results:The coincidence time of the two groups was shorter in the observation group than in the control group(t=8.387,P＜0.05).There was no statistically difference in intraoperative blood loss,total suegery time and total hospitalization time(t=1.681,0.516,1.518;P＞0.05).Between the two groups,the incidence of anastomotic stenosis,anastomotic fistula and gastroesophageal reflux in the observation group was lower than that in the control group(χ2=4.293,3.905,5.151;P＜0.05).There was no significant difference in the incidence of pulmonary complications,arrhythmia,incision infection and transient hoarseness between the observation group and the control group(χ2=0.341,0.120,1.032,0.100;P＞0.05).Compared with pre-operation,the scores of SF-36 dimensions of quality of life and the total score of SF-36 in the 2 groups were increased 6 months after surgery,and the scores in the observation group were higher than those in the control group 6 months after surgery(t=5.762,4.207,4.487,3.813,4.272,3.906,3.692,3.872,4.100;P＜0.001).Conclusion:Compared with end-to-side stratified anastomosis in thoracic laparoscopy combined with radical resection of esophageal cancer,end-to-side stratified anastomosis can shorten the intraoperative anastomosis time,reduce the risk of postoperative anastomosis complications,and improve the postoperative quality of life of patients.