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目的 通过食管胃肠线吻合术后内镜观察,证明肠线是食管胃内层缝合的理想材料.方法 随机采用“000”羊肠线(A组)和丝线(B组)施行食管癌和贲门癌切除食管胃吻合各200例.结果 两组术后并发症发生率和手术死亡率无差异,A组进普食顺利者较B组明显增多,而食管胃吻合口瘘的发生率却比B组低.术后食管造影示:逆蠕动、吻合口残留钡剂,残食管扩张和吻合口狭窄的发生率A组较B组明显降低,而且肠线缝合Ⅰ期愈合率较丝线缝合高,说明丝线长期残留是促进纤维组织增生、造成吻合口狭窄的重要原因.结论“000”肠线容易吸收,价格便宜,对组织刺激小,反应轻,吻合口愈合快,能够降低食管胃吻合口狭窄和食管胃吻合口瘘的发生率,是食管癌和贲门癌切除食管胃内层缝合的理想材料.
Objective Through endoscopic observation of esophageal gastrointestinal anastomosis, it is proved that the gut is an ideal material for the suture of the esophagus and stomach. Methods The “000” catgut (A group) and silk thread (B group) were randomly used to perform esophageal cancer and cardiac surgery. There were 200 cases of esophagogastric anastomosis with cancer resection. There was no difference in postoperative complications and operative mortality between the two groups. The incidence of postoperative complications in group A was significantly higher than that in group B, but the incidence of esophageal anastomotic leakage was higher than that of group B. The group was low. Postoperative esophageal angiography showed that the incidence of retrograde peristalsis, anastomotic residual tanning agent, residual esophageal dilation and anastomotic stenosis was significantly lower in group A than in group B, and the healing rate of gut suture at the stage I was higher than that of silk suture. Long-term residue of silk is an important reason for promoting fibrous tissue hyperplasia and anastomotic stenosis. Conclusion “000” gut is easy to absorb, cheap, small tissue stimulation, light response, fast anastomotic healing, can reduce esophageal gastric anastomotic stenosis and The incidence of esophagogastric anastomotic leakage is an ideal material for esophagogastric endogastric suturing of esophageal and cardiac cancers.