Pleshkov V G, Afanas'ev V N, Babichev A V
Khirurgiia (Mosk). 1998(11):27-9.
110 cases of resection of the stomach with transection of the stomach and the duodenum by plasmic scalpel and suturing of curvatura minor of the stump and anastomosis with the use of original one-layer sero-muscular-submucosal suture have been analysed. Changes in gastric wound at the site of plasma transection were evaluated microscopically. It was established that plasma transection of the stomach is aseptic, hemostatic, thermal trauma is minimal and does not exceed the level of 3-4 mm from transection line. Favourable conditions for applications of one-layer suture contribute much to a decrease of the number of stitch puncture, to rejection of catgut, to reduction of tissue mass involved and deformation of intestinal wall. In the early postoperative period wound and anastomoses healing occurred without substantial inflammatory changes. 109 patients were operated by Billroth-1 and 1 patient--by Billroth-II. One patient died (lethality 0.9%). Early postoperative complications occurred in 7.2% of operated patients.
对110例行胃切除术的病例进行了分析,手术采用等离子手术刀切断胃和十二指肠,并使用原创的单层浆膜-肌层-黏膜下层缝合技术对残端小弯进行缝合及吻合。通过显微镜评估了等离子切割部位胃伤口的变化。结果表明,胃的等离子切割是无菌的、止血的,热损伤极小,不超过切割线3-4毫米的水平。单层缝合应用的有利条件大大减少了缝线穿刺的次数,减少了肠线的排斥反应,减少了涉及的组织量和肠壁变形。术后早期伤口和吻合口愈合良好,无明显炎症变化。109例患者行毕罗一式手术,1例患者行毕罗二式手术。1例患者死亡(致死率0.9%)。7.2%的手术患者出现早期术后并发症。