管状吻合器及缝合器在Roux-en-Y上消化道重建术中临床应用.docVIP

管状吻合器及缝合器在Roux-en-Y上消化道重建术中临床应用.doc

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管状吻合器及缝合器在Roux-en-Y上消化道重建术中临床应用

管状吻合器及缝合器在Roux-en-Y上消化道重建术中临床应用[摘要] 目的:探讨使用管状吻合器及缝合器在Roux-en-Y上消化道重建术中的临床应用价值。方法:回顾性分析本院 2000年1月~2010年1月329例应用管状吻合器及缝合器行Roux-en-Y近端胃切除和全胃切除手术患者的临床资料与并发症的发生率。结果:全组均获手术成功,无手术死亡病例,手术时间1.6~4.0 h,平均2.8 h,无吻合口瘘、出血及狭窄等严重并发症。术后随访0.5~2年,发生吻合口狭窄3例,经放置支架后恢复正常饮食,其余患者胃镜或钡餐示吻合口愈合良好,进食状态良好。结论:Roux-en-Y上消化道重建术中应用管状吻合器及缝合器具有操作简单、安全有效,手术时间短、并发症少等优点,有较高的临床应用价值。 [关键词] 管状吻合器;缝合器;上消化道;胃切除;重建术;Roux-en-y吻合 [中图分类号] R656.6+1 [文献标识码]A[文章编号]1674-4721(2011)08(a)-033-02 Clinical application of tubular anastomat and stapler in Roux-en-Y upper gastrointestinal reconstruction LIANG Chaoxu, ZHANG Yijie* Department of Surgical, Huaiji People’s Hospital, Guangdong Province, Huaiji526400, China [Abstract] Objective: To investigate the clinical application value of tubular anastomat and stapler in Roux-en-Y upper gastrointestinal reconstruction. Methods: 329 patients receiving Roux-en-Y proximal gastric resection and total gastrectomy using tubular anastomat and stapler in our hospital from January 2000 to January 2010 were analyzed retrospectively. Results: All the surgeries were successful and there was no surgical death. The surgical time ranged from 1.6 to 4.0 hours, with an average of 2.8 hours. There were no anastomotic leak, bleeding, stenosis and other serious complications. After follow-up for 0.5 to 2 years, anastomotic stenosis occurred in 3 patients, who regained normal diet after stent placement. Endoscopy or barium meal showed good anastomotic healing in the other patients and the eating conditions were good. Conclusion: Application of tubular anastomat and stapler in Roux-en-Y upper gastrointestinal reconstruction has advantages such as simple operation, safe and effective, shorter surgical time and fewer complications, thereby of high clinical application value. [Key words] Tubular anastomat; Stapler; Upper gastrointestinal; Gastrectomy; Reconstruction; Roux-en-Y anastomosis 目前外科手术仍是能治愈胃癌的唯一方法,为了简化手术操作,提高手术质量;同时减少吻合口瘘、出血、狭窄等严重并发症的发生以及改善患者术后生活质量,近年来吻合器及缝合器在近端胃切除和全胃

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