全胃切除空肠代胃术中空肠—空肠机械侧侧吻合的临床研究:附84例临床随机对照研究  

Cardia cancer Jejunum in gastric jejunum-jejunum side anastomosis using mechanical anastomosis-84 cases of clinical randomized controlled study

作　　者：郭睿[1] 肖开提.买买提伊明 努尔兰.阿汗 

机构地区：[1]新疆维吾尔自治区人民医院胸外科,乌鲁木齐830001

出　　处：《中华胃食管反流病电子杂志》2015年第4期217-220,共4页Chinese Journal Of Gastroesophageal Reflux Disease(Electronic Edition)

摘　　要：目的探讨贲门癌全胃切除术消化道重建中机械吻合替代手工吻合的应用价值和临床疗效。方法选取新疆维吾尔自治区人民医院胸外科2012年1月至2014年12月收治的临床诊断为贲门癌需行全胃切除空肠代食管术治疗的患者,共84例,按照随机对照研究方法随机分为机械吻合组和手工吻合组各42例,比较两组手术患者的手术情况、与吻合方式相关的术后并发症情况以及远期预后情况。结果机械吻合组的手术时间、术中出血量、吻合口狭窄的发生率均低于手工吻合组(P<0.05);住院时间、吻合口瘘的发生率两组比较差异无统计学意义(P>0.05);机械吻合组的住院费用高于手工吻合组(P<0.05)。结论与传统的手工分层吻合比较,在贲门癌消化道重建术中空肠-空肠侧侧吻合运用机械吻合相对操作简便,能够缩短手术时间、弥补手工吻合所产生的操作不当,降低术后空肠-空肠侧侧吻合口内径过大或过小的发生率,值得临床广泛应用开展。Objective Discuss all gastric cardia cancer resection of mechanical anastomosis in the digestive tract reconstruction replace manual consistent application value and the clinical curative effect. Methods Selected department from January 2012 to December 2012 were clinical diagnosis of cardia cancer requires full stomach resection for the treatment of esophagus jejunum generation of patients, a total of 84 cases,according to a randomized controlled study methods were randomly divided into mechanical anastomosis of and manual anastomosis of the 42 cases, compared two groups of patients with surgical operation, postoperative complications associated with consistent way and long-term prognosis. Results Mechanical anastomosis of the operation time,intraoperative blood loss,the incidence of anastomotic stenosis were lower than that of manual anastomosis group （ P 〈0. 05 ）;Length of hospital stay, the incidence of anastomotic fistula is similar between the two groups had no statistical significance（P〉0. 05）;Mechanical anastomosis of hospitalization cost is higher than manual anastomosis group （ P〈0. 05 ） . Conclusion Compared with the traditional manual layered anastomosis, the digestive tract in cardia cancer revascularization in jejunum-jejunum side side anastomosis using mechanical anastomosis is relatively easy to operate, can shorten the operation time, make up for the manual data generated by improper operation, reduce the incidence of postoperative anastomotic is too big or small,is worth wide application in the clinical practice.

关 键 词：贲门癌 消化道重建 吻合术 机械吻合 

分 类 号：R735.2[医药卫生—肿瘤]