Department of Surgery, Jikei University School of Medicine, 3-25-8 Nishi-Shinbashi Minato-ku, Tokyo, 105-8471, Japan.
Surg Endosc. 2010 Oct;24(10):2633-6. doi: 10.1007/s00464-010-1007-0. Epub 2010 Mar 31.
Anastomotic impairment can be a major cause of surgical complications in gastrointestinal surgery. The aim of this study was to evaluate the efficacy of intraoperative endoscopy (IOE) in esophagojejunal anastomosis for detection of anastomotic impairment.
Forty-eight patients who underwent total gastrectomy were evaluated for the integrity of the esophagojejunostomy using IOE at completion of mechanical esophagojejunal anastomosis.
Overall postoperative anastomotic leakage (PAL) rate was 4.2% (n = 2/48). Both patients who developed PAL had abnormal findings such as mucosal defect in the esophageal mucosa or incomplete anastomotic stapling. Also, IOE revealed inadvertent anastomotic failure in three patients: two jejunal and one esophageal occlusion. There were no complications due to IOE.
IOE is safe and may easily provide significant information that can minimize PAL by detecting anastomotic failure on esophagojejunal anastomosis.
吻合口损伤是胃肠外科手术中发生手术并发症的一个主要原因。本研究旨在评估术中内镜（IOE）在食管空肠吻合术中检测吻合口损伤的效果。
对 48 例行全胃切除术的患者，在机械性食管空肠吻合完成时使用 IOE 评估食管空肠吻合口的完整性。
总术后吻合口漏（PAL）发生率为 4.2%（n=48）。发生 PAL 的 2 例患者均有异常发现，如食管黏膜黏膜缺损或不完全吻合钉合。此外，IOE 还发现了 3 例意外的吻合口失败：2 例空肠和 1 例食管阻塞。IOE 无并发症发生。
IOE 是安全的，通过检测食管空肠吻合口的吻合口失败，可能很容易提供重要信息，从而最大限度地减少 PAL。
