Schwameis K, Zacherl J
Universitätsklinik für Chirurgie, Medizinische Universität Wien, AKH Wien, Österreich.
Chirurg. 2011 Jan;82(1):26, 28-33. doi: 10.1007/s00104-010-1900-z.
Anastomotic leaks are the major postoperative complications mainly due to technical difficulties. The aim was to review anastomotic techniques and risk factors for leak development.
A Pubmed search was performed using the terms esophagogastric/esophagojejunal anastomosis, gastrojejunostomy, gastric bypass, esophagectomy, anastomotic leak/risk factors, gastrectomy, TEA, fluid management, early enteral feeding and reinforcement. English and German literature sources were included with the accent on recent prospective randomized controlled trials (pRCT) with high numbers of cases as well as meta-analyses.
There is not enough evidence to recommend either hand sewn or mechanical anastomoses. Surgical skills and routine as well as precise work are necessary to reduce complications. Although stapling leads to uniformity of anastomoses it cannot compensate for surgical deficits.
吻合口漏是主要由于技术困难导致的主要术后并发症。目的是回顾吻合技术及漏发生的危险因素。
使用食管胃/食管空肠吻合术、胃空肠吻合术、胃旁路术、食管切除术、吻合口漏/危险因素、胃切除术、TEA、液体管理、早期肠内营养和加强等术语在PubMed上进行检索。纳入英文和德文文献来源，重点是近期大量病例的前瞻性随机对照试验（pRCT）以及荟萃分析。
没有足够证据推荐手工缝合或机械吻合。手术技巧、常规操作以及精确操作对于减少并发症是必要的。尽管吻合器能使吻合口均匀一致，但它无法弥补手术缺陷。
