Kimura Masahiro, Mitsui Akira, Kuwabara Yoshiyuki
Department of Surgery, Nagoya City East Medical Center, 2-23 Wakamizu 1, Chikusa-ku, Nagoya 464-1308, Japan.
Department of Surgery, Nagoya City West Medical Center, Japan.
Ann Med Surg (Lond). 2016 Jan 27;6:42-5. doi: 10.1016/j.amsu.2016.01.080. eCollection 2016 Mar.
Various types of staplers are used for gastric tube formation after esophagectomy. Using a stapling device, a gastric tube can safely be created in a short amount of time. The problems with gastric tube creation using only linear type staplers include staple overlap as well as the problem of cost associated with using multiple staplers. To address this, both linear and radial type staplers have been introduced. We herein compare three methods of gastric tube creation.
From 2012 to 2014, 62 patients with esophageal cancer underwent esophagectomy with gastric tube reconstruction. We evaluated and compared the mean number of stapler loads and cost in each groups.
The mean number of stapler loads was 6.24 in method A, 5.16 in method B, and 4.33 in method C. The mean cost accounting for total staple fires per case was 3116.07 dollars in the method A group, 2576.74 dollars in the method B group, and 2447.78 dollars in the method C group. Anastomotic leaks developed in 4 cases in the method A group and in 3 cases in the method B group. There were no anastomotic leaks in the method C group.
We hypothesize that by using radial type staplers, we can create a durable gastric tube and reduce the number of staplers and therefore reduce operative cost.
食管癌切除术后，各种类型的吻合器被用于制作胃管。使用吻合器装置，可以在短时间内安全地制作胃管。仅使用直线型吻合器制作胃管存在钉合重叠以及使用多个吻合器带来的成本问题。为解决这一问题，直线型和圆形吻合器都已被引入。我们在此比较三种制作胃管的方法。
2012年至2014年，62例食管癌患者接受了食管癌切除及胃管重建手术。我们评估并比较了每组中吻合器钉仓的平均使用数量和成本。
方法A组吻合器钉仓的平均使用数量为6.24个，方法B组为5.16个，方法C组为4.33个。方法A组每例患者总的吻合器击发平均成本为3116.07美元，方法B组为2576.74美元，方法C组为2447.78美元。方法A组有4例发生吻合口漏，方法B组有3例发生吻合口漏。方法C组未发生吻合口漏。
我们推测，使用圆形吻合器可以制作出耐用的胃管，减少吻合器的数量，从而降低手术成本。
