应用手工缝合与单、双吻合器吻合行直肠癌前切除术疗效比较

目的探讨中低位直肠癌患者行结直肠吻合的方式及其疗效。方法 2006年1月～2011年12月行手术治疗的中低位直肠癌患者130例,其中行手工缝合者28例,单吻合器吻合49例,双吻合器吻合53例,采用病例对照研究回顾性分析三组的临床效果。结果三组患者手术均获成功,无围手术期死亡。单吻合器组和双吻合器组在手术时间、术中出血量上优于手工缝合组(P<0.05),但单、双吻合器组之间无统计学差异(P>0.05)。双吻合器组的住院费用远高于手工缝合组(P<0.05),但与单吻合器组比较无差异(P>0.05),手工缝合与单吻合器比较亦无差异(P>0.05)。而在吻合口瘘、吻合口狭窄、吻合口出血的发生率及住院时间方面,三组间比较无明显差异(P>0.05)。结论吻合器的使用能提高中低位直肠癌根治术时结直肠吻合的吻合效率,应首选使用;而手工缝合的并发症发生率也呈下降趋势。

Curative Effect Comparison between the Manual Suturing and Stapling for Colorectal Anastomosis in the Anterior Resection of Rectal Cancers

Objective To compare the curative effect of colorectal anastomosis made by the manual suturing and stapling for the anterior resection of rectal cancers.Method The case-control study was applied to analyze the clinical outcomes of the 130 cases with rectal cancer,in which 28 cases were undergone by manual suturing,49 cases by single stapler and 53 cases by double staplers.Results All the three groups of patients got successful operations without perioperative death.It was better in the single stapling group and double stapling group than in the manual suture group(P<0.05) of the operative time and blood loss,but there was significant difference between the single and double stapling groups(P>0.05).In the double stapling group,the hospital charges was much higher than the manual suture group(P<0.05),but had no difference comparing with the single stapling group(P>0.05).The manual suture group and the single stapling group also had no difference(P>0.05).In the rate of anastomotic leakage,anastomotic stricture and anastomotic bleeding,and the duration of hospitalization,there was no significant difference among the three groups(P>0.05).Conclusion The use of the staplers can improve colorectal anastomosis efficiency,and should be preferred in the low rectal cancer patients.