Department of Surgery, Dong-A University College of Medicine, Busan, Korea.
J Gastric Cancer. 2012 Jun;12(2):120-5. doi: 10.5230/jgc.2012.12.2.120. Epub 2012 Jun 27.
Mechanical stapler is regarded as a good alternative to the hand sewing technique, when used in gastric reconstruction. The circular stapling method has been widely applied to gastrectomy (open orlaparoscopic), for gastric cancer. We illustrated and compared the hand-sutured method to the circular stapling method, for Billroth-II, in patients who underwent laparoscopy assisted distal gastrectomy for gastric cancer.
Between April 2009 and May 2011, 60 patients who underwent laparoscopy assisted distal gastrectomy, with Billroth-II, were enrolled. Hand-sutured Billroth-II was performed in 40 patients (manual group) and circular stapler Billroth-II was performed in 20 patients (stapler group). Clinicopathological features and post-operative outcomes were evaluated and compared between the two groups.
Nosignificant differences were observed in clinicopathologic parameters and post-operative outcomes, except in the operation times. Operation times and anastomosis times were significantly shorter in the stapler group (P=0.004 and P<0.001).
Compared to the hand-sutured method, the circular stapling method can be applied safely and more efficiently, when performing Billroth-II anastomosis, after laparoscopy assisted distal gastrectomy in patients with gastric cancer.
在胃重建中，机械吻合器被认为是一种替代手工缝合技术的良好选择。圆形吻合器已广泛应用于胃癌的开腹或腹腔镜胃切除术。我们通过对比，展示了在腹腔镜辅助下远端胃癌根治术中，行毕Ⅱ式吻合时，手工缝合与圆形吻合器的应用。
2009 年 4 月至 2011 年 5 月，我们共纳入 60 例行腹腔镜辅助远端胃癌根治术、行毕Ⅱ式吻合的患者。其中 40 例行手工缝合毕Ⅱ式吻合（手工组），20 例行圆形吻合器毕Ⅱ式吻合（吻合器组）。评估并比较两组患者的临床病理特征和术后结局。
两组患者的临床病理参数和术后结局无显著差异，除手术时间外。吻合器组的手术时间和吻合时间明显短于手工组（P=0.004 和 P<0.001）。
与手工缝合相比，在腹腔镜辅助下远端胃癌根治术中行毕Ⅱ式吻合时，圆形吻合器可更安全、更有效地应用。
