Murayama I, Sato H, Suzuki T, Ootsuka Y, Song K, Yamagata M, Fukase T, Iwai S
Third Department of Surgery, Nihon University School of Medicine, Tokyo, Japan.
J Laparoendosc Adv Surg Tech A. 1998 Oct;8(5):295-301. doi: 10.1089/lap.1998.8.295.
To prevent stricture of an anastomotic site after operation of esophageal cancer, a new surgical technique, the "double-stapling method," was designed and applied clinically to 29 patients. According to the surgical technique, an automatic suture device for endoscopy was inserted from the side of the lesser curvature of the stomach to the esophageal side after performing end-side anastomosis between the esophagus and the stomach tube using a conventional circular anastomotic device to perform anastomosis between the anterior wall of the esophagus and the posterior wall of the stomach tube. As a result, a conventional anastomotic site, which was a plane (two dimensional), was transformed into a three-dimensional configuration. In the postoperative measurement of the anastomotic site using a measurement forceps, the inner diameter of the site was 8.6+/-3.1 mm in the circular group, while it was 17.2+/-4.5 mm in the DS group, showing a significant difference (p < 0.0001). Minor leakage was observed in three patients as a postoperative complication, but no postoperative hemorrhage occurred.
为预防食管癌术后吻合口狭窄，设计了一种新的手术技术“双吻合器法”，并应用于29例临床患者。根据该手术技术，在用传统圆形吻合器完成食管与胃管端侧吻合后，从胃小弯侧插入内镜自动缝合装置至食管侧，进行食管前壁与胃管后壁之间的吻合。结果，传统的呈平面（二维）的吻合口转变为三维结构。术后用测量钳测量吻合口，圆形吻合器组吻合口内径为8.6±3.1mm，双吻合器组为17.2±4.5mm，差异有统计学意义（p<0.0001）。术后并发症有3例出现轻微渗漏，但无术后出血发生。
