Fujimoto S, Takahashi M, Endoh F, Takai M, Kobayashi K, Kiuchi S, Konno C, Obata G, Okui K
First Department of Surgery, School of Medicine, Chiba University, Japan.
Am J Surg. 1991 Sep;162(3):256-9. doi: 10.1016/0002-9610(91)90081-n.
From January 1983 to December 1989, we performed esophagojejunostomy on 379 patients who underwent total gastrectomy for gastric cancer. A mechanical EEA stapler or conventional manual suturing was used. The clinical outcomes of 199 patients in whom stapling was used (stapler group) and 180 patients in whom manual suturing was done (manual group) were compared. Two of the 199 patients in the stapler group and 3 of the 180 patients in the manual group died of causes directly related to the anastomosis. In the stapler group, 16 stapled anastomoses were formed supradiaphragmatically, and manual suturing was done for 6 patients. The highly placed anastomosis was formed without left thoracotomy or with median sternotomy in 8 of the 16 patients in whom the stapling device was used and in 1 of the 6 patients in whom manual suturing was used. The incidence of anastomotic leakage and stenosis did not differ between the groups. Thus, the mechanical stapler facilitated the construction of a rapid, reliable esophagojejunostomic anastomosis.
1983年1月至1989年12月，我们对379例因胃癌接受全胃切除术的患者施行了食管空肠吻合术。采用了机械EEA吻合器或传统手工缝合。比较了199例使用吻合器的患者（吻合器组）和180例进行手工缝合的患者（手工组）的临床结局。吻合器组的199例患者中有2例、手工组的180例患者中有3例死于与吻合直接相关的原因。在吻合器组中，16例吻合在膈上进行，6例患者进行了手工缝合。在使用吻合器的16例患者中的8例以及进行手工缝合的6例患者中的1例中，高位吻合在未行左开胸或正中胸骨切开的情况下完成。两组之间吻合口漏和狭窄的发生率没有差异。因此，机械吻合器有助于快速、可靠地构建食管空肠吻合口。
