Cai C J, Wang C P
Department of Surgery, Zhong Shan Hospital, Shanghai Medical University, China.
Br J Surg. 1988 Nov;75(11):1098-9. doi: 10.1002/bjs.1800751116.
Thirty-five gastrofundic devascularization procedures were performed with the side-to-side CF stapler of Chinese manufacture for obliteration of oesophagogastric varices. Four patients were operated on as emergencies, six patients 2-3 weeks after control of bleeding by tamponade and the remaining twenty-five electively (including four patients who had not bled). There were two operative deaths, an operative mortality of 6 per cent. In all, 30 patients have been followed, 20 for 1-3 years and 10 for less than 1 year. Twenty-five patients had postoperative barium meal examination. The varices were ameliorated in 19, not changed in 5 and exacerbated in 1. Nine patients rebled and of these, two died. The stapler is used in devascularization to interrupt intramural varices in the oesophagocardiac region. It must be emphasized that its use is only a part of the devascularization procedure. When used alone devascularization is not complete. The side-to-side stapler appears to be a convenient, safe and rational instrument for use in devascularization.
采用国产侧侧吻合器行胃底贲门去血管化术35例，以闭塞食管胃底静脉曲张。4例为急诊手术，6例在压迫止血控制出血后2 - 3周手术，其余25例为择期手术（包括4例未出血者）。手术死亡2例，手术死亡率为6%。共有30例患者得到随访，20例随访1 - 3年，10例随访不足1年。25例患者术后行钡餐检查。静脉曲张改善者19例，无变化者5例，加重者1例。9例再出血，其中2例死亡。吻合器用于去血管化术以阻断食管贲门区域的壁内静脉曲张。必须强调的是，其应用仅是去血管化手术的一部分。单独使用时去血管化并不彻底。侧侧吻合器似乎是一种用于去血管化的方便、安全且合理的器械。
