Deltz E
Abtlg. Allgemeine Chirurgie, Universitätsklinik Kiel.
Langenbecks Arch Chir Suppl II Verh Dtsch Ges Chir. 1989:371-5.
Special technical procedures are the prerequisite for the successful use of stapling techniques in surgery of the upper GI tract. Organ surfaces which are to be connected by staplers have to be cleaned meticulously of all fat and mesenterium. Purse string sutures in the hiatus oesophagei should be done by hand. The instrument has to be inserted carefully to avoid leasons of the mesenterium. Kinking of bowel segments has to be avoided; the bowel or gastric segments must be spread over the circular staplers. Anastomoses should be checked for bleeding and patency. Thus stapling can be done successfully in routine resections of the stomach and in the transabdominal approach to cardia region and lower esophagus.
特殊技术操作是在上消化道手术中成功使用吻合器技术的前提条件。要用吻合器连接的器官表面必须仔细清除所有脂肪和肠系膜。食管裂孔处的荷包缝合应手工完成。器械必须小心插入,以免损伤肠系膜。必须避免肠段扭结;肠段或胃段必须摊开覆盖在圆形吻合器上。应检查吻合口有无出血和通畅情况。这样,在胃的常规切除以及经腹途径处理贲门区和食管下段时,吻合操作就能成功完成。