在全胃切除术后的食管空肠吻合术中，线性吻合器可形成更好的吻合口。
Linear stapling forms improved anastomoses during esophagojejunostomy after a total gastrectomy.
作者信息
Matsui Hideo, Uyama Ichiro, Sugioka Atsushi, Fujita Junko, Komori Yoshiyuki, Ochiai Masahiro, Hasumi Akitake
机构信息
Department of Surgery, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukakecho, Toyoake, Aichi 470-1192, Japan.
出版信息
Am J Surg. 2002 Jul;184(1):58-60. doi: 10.1016/s0002-9610(02)00893-0.
BACKGROUND
Circular stapling devices are commonly used to form esophagojejunal anastomoses after total gastrectomy. However, the technique has potential problems with placement of the purse-string suture and insertion of the anvil of the instrument.
METHODS
We describe an improved technique for esophagojejunostomy by functional end-to-end anastomosis with linear stapling devices.
RESULTS
Three patients with gastric cancer underwent this procedure after total gastrectomy. No anastomotic leakage or clinical evidence of stenosis was encountered. The maximum diameters of the anastomoses, evaluated by radiography with barium at 6 months after surgery, were 3.5 cm and 4.0 cm in 2 patients. Endoscopic examination revealed clear lines of anastomosis with a straight continuity between the distal esophagus and the jejunum.
CONCLUSIONS
Our improved technique for esophagojejunostomy by functional end-to-end anastomosis with two linear staplers is a convenient, safe and reliable procedure that is independent of the width of the esophagus and the depth of the esophageal hiatus.
背景
在全胃切除术后，圆形吻合器常用于构建食管空肠吻合口。然而，该技术在荷包缝合的放置和器械钉砧的插入方面存在潜在问题。
方法
我们描述了一种使用线性吻合器进行功能性端端吻合的改良食管空肠吻合技术。
结果
3例胃癌患者在全胃切除术后接受了该手术。未发生吻合口漏或狭窄的临床证据。术后6个月通过钡剂造影评估，2例患者吻合口的最大直径分别为3.5 cm和4.0 cm。内镜检查显示吻合线清晰，食管远端与空肠之间呈直线连续。
结论
我们采用两把线性吻合器进行功能性端端吻合的改良食管空肠吻合技术是一种方便、安全且可靠的手术方法，不受食管宽度和食管裂孔深度的影响。
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