CAJ | 학술논문

目的观察食管肿瘤、贲门癌切除后应用管型吻合器吻合的手术效果.方法食管、贲门癌切除后应用管型吻合器吻合患者1800例,采用管型吻合器行食管-胃颈部吻合182例、食管-胃、食管-空肠胸内吻合1296例、腹腔内吻合322例.观察应用上海GF-I型和YH-W一次性管型消化道吻合器致吻合口瘘、吻合口狭窄、吻合口出血和吻合器机械故障等并发症发生率.结果术后发生吻合口瘘15例(15/1800,0.83%,上海GF-I型吻合器10例,YH-W一次性吻合器5例,χ2=11.32,P=0.0089),其中颈部吻合口瘘6例;吻合口狭窄41例(41/1800,3.11%,上海GF-I型吻合器15例,YH-W一次性吻合器26例,χ2=3.842,P=0.0840),吻合口狭窄经扩张均恢复正常饮食.吻合口出血21例(21/1800,1.16%,上海GF-I型吻合器13例,YH-W一次性吻合器8例,χ2=15.38,P=0.0046).术中出现吻合器机械故障14例(14/1800,0.78%,上海GF-I型吻合器10例,YH-W一次性吻合器4例,χ2=14.52,P=0.0075).结论机械吻合是减少食管肿瘤、贲门癌术后并发症有效方法之一,YH-W一次性吻合器具有更高的临床应用价值.
목적 관찰식관종류、분문암절제후응용관형문합기문합적수술효과.방법 식관、분문암절제후응용관형문합기문합환자1800례,채용관형문합기행식관-위경부문합182례、식관-위、식관-공장흉내문합1296례、복강내문합322례.관찰응용상해GF-I형화YH-W일차성관형소화도문합기치문합구루、문합구협착、문합구출혈화문합기궤계고장등병발증발생솔.결과 술후발생문합구루15례(15/1800,0.83%,상해GF-I형문합기10례,YH-W일차성문합기5례,χ2=11.32,P=0.0089),기중경부문합구루6례;문합구협착41례(41/1800,3.11%,상해GF-I형문합기15례,YH-W일차성문합기26례,χ2=3.842,P=0.0840),문합구협착경확장균회복정상음식.문합구출혈21례(21/1800,1.16%,상해GF-I형문합기13례,YH-W일차성문합기8례,χ2=15.38,P=0.0046).술중출현문합기궤계고장14례(14/1800,0.78%,상해GF-I형문합기10례,YH-W일차성문합기4례,χ2=14.52,P=0.0075).결론 궤계문합시감소식관종류、분문암술후병발증유효방법지일,YH-W일차성문합기구유경고적림상응용개치.
Objective To analyse the effects of anastomat to the resection surgery in 1800 esophageal and gastric cardiac carcinoma patients. Methods The Esophagus-gaster and Esophagus-intestine were stapled by anastomat in the cervical region in 182 cases、 intrathoracically in 1296 cases and intraperitoneal in 322cases. The occurrence of complications caused by anastomat, including anastomotic fistula,anastomotic stricture,anastomotic bleeding and mechanical failure,were observed. Results Anastomotic fistula occurred in 15 cases ( 15/1800,0.83% ,ten cases took Shanghai-made GF-I anastomat ,five cases took YH-W single disposable single anastomat ), among which 6 cases had the cervical anastomosis; Anastomotic stricture occurred in 41 cases ( 41 /1800,3.11%, fifteen cases took Shanghai-made GF-I anastomat, twenty-six took YH-W single disposable single anastomat) ,but all of them recovered after dilatation; Anastomotic bleeding occurred in 21 cases (21/18001.16%, thirteen cases took Shanghai-made GF-I anastomat, eight took YH-W single disposable single anastomat) ;Anastomat mechanical failure in operation occurred in 14 cases( 14/1800,0. 78% ,ten cases took Shanghai-made GF-I anastomat, four took YH-W single disposable single anastomat). Conclusion Anastomat is an effective method in reducing the postoperational complications of esophageal and gastric cardiac carcinoma resection. Disposable single anastomat has higher clinical value.