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[全胃切除术后用端端吻合器进行食管空肠吻合术。关于近期32例病例的技术及近期结果]

[Esophagojejunal anastomoses with the EEA stapler after total gastrectomy. Technic and immediate results apropos of a recent series of 32 cases].

作者信息

Le Treut Y P, Delpero J R, Sabiani P, Berthet B, Bozon-Verduraz E, Pol B, Bricot R

机构信息

Service de Chirurgie Générale et Digestive, Hôpital de la Conception, Marseille.

出版信息

J Chir (Paris). 1987 Dec;124(12):695-700.

PMID:3436987
Abstract

32 consecutive total gastrectomies for cancer (20 extended total gastrectomies) were carried out through an abdominal approach. Reconstruction using a Rouxen-Y loop (28 cases) or an interposed jejunal loop (four cases) was done with an EEA stapled oesophago jejunostomy: 25 end to side and 5 end to end anastomosis were performed and two technical failures led to complete manual anastomosis. All patients have had post-operative X-ray examination: there was no anastomotic leakage in this series, even in the 3 patients (10%) who have died during the post-operative course. A critical study of this series and eight others one from elsewhere is presented: it is concluded that the stapling device allows an easier and safer oesophagojejunostomy than manual procedure, when great care is taken of technical details.

摘要

对32例癌症患者实施了连续的经腹全胃切除术(其中20例为扩大全胃切除术)。采用Rouxen-Y袢(28例)或间置空肠袢(4例)进行重建,并使用EEA吻合器行食管空肠吻合术:25例为端侧吻合,5例为端端吻合,2例技术失败后改为完全手工吻合。所有患者均接受了术后X线检查:本系列中无吻合口漏发生,即使在术后病程中死亡的3例患者(10%)中也未出现。本文对本系列及其他地区的8个系列进行了批判性研究:得出的结论是,在严格注意技术细节的情况下,吻合器行食管空肠吻合术比手工操作更容易、更安全。

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