用吻合器行食管胃胸内吻合术连续300例无吻合口瘘报告

本文报告了使用国产GF-I型管状消化道吻合器,连续行食管胃胸内吻合术300例未发生吻合口瘘的经验。患者均为住院患者,其中食管癌191例,贲门癌109例。切除癌肿后,食管胃端侧全层内翻吻合均用吻合器完成,并用胃壁组织包埋吻合口一周。术后,12例患者发生胸内出血、呼吸机能不全、脓胸、胃排空障碍以及吻合口狭窄等并发症;除2例吻合口狭窄可能与吻合器本身有关外,其余并发症与吻合器无因果关系。经验表明,用吻合器行食管胃朐内吻合术,具有操作简便、安全、可靠、省时等优点,其效果明显优于手工吻合,是预防吻合口瘘的有效手段之一。近7年间,本科用吻合器行食管胃胸内吻合术745例,吻合口瘘发生率为1％,与1979年以前的手工吻合组比较,吻合口瘘发生率下降4.6％。

A report in 300 consecutive patients for intrathoracic esophagogastic anastomosis and without leakage with GF-I type stapler

THIS paper repoted the experience with the use of GF-Itype slapler for intrathoracic esophagogastric end-to-side anastomosis in 300 consecutive patients with carcinoma of the esophagus or cardia from July 1985 through match 1988. ALL tumors in these 300 cases were resected surgically and intrathoracic esophagogastrostomy was performed with this stapler unit and there was no suture-line leakage at in any of the 300 cases. The operative results were satisfactory and encouraging. The leak at the suture line seems to be avoided by the use of this stapler. The technical aspects of using this stapler are emphasized. 12 of 300 patients have few postoperative complications, but none of them have beeu proved to be related to the stapling device. The instrument saves time and, createsa better anastomosis than that can be obtained by hand sewing. Thus, It seems to be rather versatile and its use is recommended. Hcwever, it should be used only after the surgeon has acpuired the skills to handle the stapler properly. The instrument appears to open a new way in thoracic surgery and esophagogastric anastomosis. It is an effective procedure to prevent the postoperative leak.