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目的 评价颈部与胸部吻合对食管癌切除患者并发症的影响.方法 计算机检索PubMed、EMbase、The Cochrane Library(2014年第10期)、Web of Science、CBM、CNKI、VIP和万方数据库,检索时限均为各数据库建库至2014年10月30日,收集颈部吻合与胸部吻合对食管癌切除患者并发症影响的随机对照试验(RCT),评价纳入文献质量,用RevMan 5.2软件进行Meta分析.结果 纳入4个RCT,共267例患者.Meta分析结果显示:两组吻合口瘘发生率差异有统计学意义(RR=3.83,95％CI 1.70～8.63,P=0.001),颈部吻合高于胸部吻合.而两组吻合口狭窄发生率(RR=1.04,95％CI 0.62～1.76,P=0.87)、肺部并发症发生率(RR=0.73,95％CI0.27 ～ 1.91,P=0.52)和死亡率(RR=0.89,95％CI0.40～1.97,P=0.77)差异均无统计学意义.结论 与胸部吻合相比较,颈部吻合提高了术后吻合口瘘的发生率,但关于术后吻合口狭窄和肺部并发症等仍存在不确定因素,有待进一步研究.“,”Objective To evaluate the effect on complication after esophagectomy by comparing the different methods of anastomosis (cervical versus thoracic anastomosis).Methods We searched the following databases including PubMed,EMbase,The Cochrane Library,Web of Science,CBM,CNKI,VIP and Wanfang database to identify randomized controlled trials (RCTs) of cervical versus thoracic anastomosis for esophagectomy patients from establishment of each database to October 30,2014.Quality of the included RCT was evaluated.Meta-analysis was conducted by using RevMan 5.2 software.Results We finally identified 4 RCTs involving 267 patients.In terms of the postoperative complication,the incidence of anastomotic leakage (RR=3.83,95％CI 1.70 to 8.63,P=0.001) with cervical anastomosis was significantly higher than that of the patients with thoracic anastomosis.However,there was no statistical difference in incidence of anastomotic stricture (RR=1.04,95％CI 0.62 to 1.76,P=0.87),pulmonary complication (RR=0.73,95％CI 0.27 to 1.91,P=0.52),and mortality (RR=0.89,95％CI 0.40 to 1.97,P=0.77) between cervical and thoracic anastomosis.Conclusion Compared with thoracic anastomosis,the method of cervical anastomosis is associated with a higher incidence of anastomotic leakage.But there are many unclear factors about anastomotic stricture,pulmonary complication and mortality,further measurement should be taken.