2005例食管和贲门癌切除一层吻合术的临·论著·床运用  

Clinical Application of a Singlerow Suturing for Esophagogastrostomy and Esophagoenterostomy-A Report of 2005 Cases

作　　者：石维平[1] 史宏灿[1] 肖文恩[1] 戴家麟 王佑 束余声[1] 

机构地区：[1]扬州大学医学院附属医院心胸外科

出　　处：《中国肿瘤临床与康复》1999年第3期40-41,共2页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的食管和贲门癌切除术后吻合瘘口是常见的并发症之一，为了降低吻合口瘘的发生率，我院心胸外科对食管与胃或肠的吻合方法进行了改进。方法食管与胃空肠结肠吻合采用一层吻合法，共手术２００５例，其中食管与全胃吻合１０４１例，与残胃吻合８６９例，与空肠吻合８５例，与结肠吻合１０例。结果全组术后发生吻合口瘘４１例（２．０％），死亡１５例（３６．６％）。结论经临床运用证明一层吻合术具有对合整齐血供好，肿瘤切除率高，吻合口瘘发生率低等优点。改进吻合技术，保护吻合口血供，减少术中污染，降低吻合口张力是预防吻合口瘘的重要措施。Objective Anastomotic fistula is one of common complications after esophagus and cardia resections.We improved the technique of esophago-gastrojejunocolic anastomosis to reduce happen of the fistula from June 1981 to June 1998.Methods The alimentary tract was rebuilt with the singlerow anastomosis in 2005 patients,1041 cases in this series with the anastomosis of esophagus and total stomach,869 cases with esophagus and residual stomach,85 cases with esophagojejunostomy,10 cases with esophagocologastrostomy.Results The rate of anastomotic fistula in this group was 2.0% (41/2005).The mortality was 36.6% (15/41).Conclusions The advantages of the singlerow suturing in clinical application are good blood supply,high resection rate of esophageal and cardiac carcinoma,lower fistula rate.The keys to prevent the fistula include the improvement of anastomotic technique,the preservation of the blood supply around esophagus,stomach,intestines and colon,reduction of operative contamination and anastomotic stretch.

关 键 词：食管胃吻合 一层吻合 食管癌 贲门癌 

分 类 号：R735.05[医药卫生—肿瘤] R730.56[医药卫生—临床医学]