论文部分内容阅读
1992年1月至1995年12月,作者共施行胃癌根治术共67例,根据胃肠重建方法将病人分为缝合器组和手法缝合组,前者用器械即吻合器和缝合器等进行胃肠道连续性的重建,后者用手法缝合重建胃肠连续性,两组病人的淋巴结作D_2或D_1清扫,胃作次全切除或全胃切除。两组肿瘤部位及手术类型无显著差别。两组病人无吻合口瘘,缝合器组并发乳糜腹1例,手缝组损伤左肾动脉1例,这2例均为D_4手术。缝合器组手术时间为184±30min,手缝组为268±43min;缝合器组输血量为670±210ml;手缝组输血量710±290ml。两组病人均无手术死亡。作者认为,使用吻合器和缝合器作消化道的吻合和缝合可以明显提高手术效率,利用吻合器,还可以完成比较困难的高位食管胃或食管空肠吻合。作者对使用吻合器和缝合器应注意的问题作了讨论,并呼吁国产吻合器生产厂家应研制性能更为良好的吻合器,以满足临床需要。
From January 1992 to December 1995, the authors performed a total of 67 cases of radical gastrectomy. According to the gastrointestinal reconstruction method, the patients were divided into a suturing device group and a manual suturing group. The continuity of the reconstruction, the latter hand suture reconstruction gastrointestinal continuity, lymph nodes in the two groups for D_2 or D_1 sweep, gastric subtotal or total gastrectomy. There was no significant difference between the two groups of tumor sites and surgical types. There were no anastomotic fistulas in the two groups of patients. There was one case of a fistula in the suture group and one case of a left renal artery in the hand-sewn group. These two cases all had D_4 operations. The operation time of the suturing device was 184±30min, the hand-stitched group was 268±43min, the suturing device group blood transfusion was 670±210ml, and the hand-sewn group was 710±290ml. There were no operative deaths in both groups. The authors believe that the use of stapler and stapler for digestive tract anastomosis and suture can significantly improve the surgical efficiency, the use of anastomosis, but also can complete more difficult high esophagogastric or esophageal jejunostomy. The authors discussed the issues that should be paid attention to when using staplers and staplers, and called for manufacturers of domestic staplers to develop more satisfactory staplers to meet clinical needs.