Walther B S, Oscarson J E, Graffner H O, Vallgren S, Evander A
Surgery. 1986 May;99(5):598-603.
Esophagojejunostomy after total gastrectomy was attempted in 27 operations with the EEA stapling device (U.S. Surgical Corp., Norwalk, Conn.). After removal of the specimen the anastomosis is performed with an end-to-side technique with insertion of the cartridge and its central rod through the open jejunal end. The 28 mm wide cartridge was used in 24 anastomoses and the 25 mm wide cartridge was used in two. In one case the 25 mm cartridge tore the distal esophagus, and the anastomosis had to be sutured manually. The median operation time was 305 minutes (range, 205 to 560 minutes), and the time to perform the anastomosis was 20 minutes (range, 15 to 60 minutes). Anastomotic leakage occurred in three patients, two of whom were stapled with the 25 mm cartridge. All healed with conservative treatment. One patient developed a stricture at the anastomotic site due to recurrence of the tumor. There was one hospital death. Median hospital stay was 16 days (range, 8 to 71 days) and median survival time was 11 months. It is concluded that the EEA stapler allows the construction of a fast and reliable esophagojejunostomy with good functional results after total gastrectomy for gastric cancer.
在27例手术中尝试使用EEA吻合器（美国外科公司，康涅狄格州诺沃克）进行全胃切除术后的食管空肠吻合术。切除标本后，采用端侧技术进行吻合，将钉仓及其中心杆经开放的空肠端插入。24例吻合使用了28毫米宽的钉仓，2例使用了25毫米宽的钉仓。1例中25毫米的钉仓撕裂了食管远端，不得不手工缝合吻合口。中位手术时间为305分钟（范围205至560分钟），进行吻合的时间为20分钟（范围15至60分钟）。3例患者发生吻合口漏，其中2例使用25毫米钉仓吻合。经保守治疗均愈合。1例患者因肿瘤复发在吻合口处出现狭窄。有1例医院死亡。中位住院时间为16天（范围8至71天），中位生存时间为11个月。结论是，EEA吻合器能够在胃癌全胃切除术后快速可靠地构建食管空肠吻合口，并取得良好的功能效果。
