Tărcoveanu E, Strat V, Chifan M, Dănilă N, Georgescu S, Stratan I
Centre Hospitalier Universitaire St. Spiridon Iaşi, Ière Cliníque Chirurgicale.
Rev Med Chir Soc Med Nat Iasi. 1993 Jan-Mar;97(1):411-3.
The authors present their experience in employing for the first time the mechanical circular suture with I.L.S. stapler in the surgery of 10 malignant esophagogastric tumors sited in C (4 cases) and M areas (6 cases). The disease was in stage II in 2 patients and in stage III in the remainder of 4. Three upper polar esophagogastrectomies (Akiyama technique) and 7 total gastrectomies were performed in old patients (mean age 63 years) at high surgical risk. Neither death nor fistulas were recorded. The average hospital stay was 14 days. A series of 17 patients (mean age 59 years), at medium surgical risk, with total gastrectomy for gastric carcinoma and classical suture served as controls. Five fistulas, two deaths and a two times longer hospital stay were recorded. Although the high cost of staplers prohibits the routine use of this technique, the authors demonstrate the great advantages resulting from mechanical suture in esophagogastric surgery.
作者介绍了他们首次在10例位于C区(4例)和M区(6例)的恶性食管胃肿瘤手术中使用带ILS吻合器的机械圆形缝合术的经验。2例患者疾病处于II期,其余4例处于III期。对手术风险高的老年患者(平均年龄为63岁)进行了3例上极食管胃切除术(秋山技术)和7例全胃切除术。未记录到死亡或瘘管形成情况。平均住院时间为14天。选取了17例手术风险中等、因胃癌行全胃切除术并采用传统缝合术的患者(平均年龄59岁)作为对照组。记录到5例瘘管形成、2例死亡以及住院时间延长两倍的情况。尽管吻合器成本高昂,限制了该技术的常规使用,但作者证明了机械缝合在食管胃手术中具有巨大优势。