浆肌层吻合法在结肠吻合中的应用  

Application of seromuscular layer anastomosis in colon anastomosis

作　　者：朱晓峰[1] 张涛[1] 鲁振环 ZHU Xiaofeng;ZHANG Tao;LU Zhenhuan(Department of Gastrointestinal Surgery,Yuebei People′s Hospital of Shaoguan City in Guangdong Province,Shaoguan,512025,China)

机构地区：[1]广东省韶关市粤北人民医院胃肠外科,广东韶关512025

出　　处：《中国现代医生》2021年第3期60-63,共4页China Modern Doctor

摘　　要：目的评估浆肌层吻合法在结肠吻合中的安全性和有效性。方法选取2017年8月至2018年8月粤北人民医院收治的行结肠吻合的结肠癌患者48例,按随机数字表法分为浆肌层吻合组(n=24)和二层吻合组(n=24),浆肌层吻合组行Layer to layer缝合法,二层吻合组行Albert-gambee缝合法,观察并比较两组患者围术期指标及并发症发生情况。结果浆肌层吻合组与二层吻合组吻合时出血量、吻合口漏发生率、首次肛门排气时间、首次排便时间及术后住院时间分别为(19.25±3.75)mL和(19.29±4.57)mL、8.3%和4.7%、(4.00±1.18)d和(3.79±1.18)d、(7.13±1.39)d和(7.63±1.38)d、(11.29±1.94)d和(11.71±2.26)d,两组相比,差异无统计学意义(P>0.05);浆肌层吻合组的吻合时间为(11.83±1.93)min,较二层吻合组的(21.29±1.94)min明显缩短,差异有统计学意义(P<0.05)。结论结肠吻合中运用浆肌层吻合法安全可靠。Objective To evaluate the safety and effectiveness of seromuscular layer anastomosis in colon anastomosis.Methods A total of 48 patients with colon cancer who needed to undergo colon anastomosis who were admitted to the Yuebei People′s Hospital from August 2017 to August 2018 were divided into two groups including the seromuscular layer anastomosis group(n=24)and the two-layer anastomosis group(n=24)according to random number table method.The seromuscular layer anastomosis group underwent the layer to layer suture method.The two-layer anastomosis group underwent the Albert-gambee suture method.The perioperative indicators and complications were observed and compared between the two groups.Results The differences of the blood loss during anastomosis([19.25±3.75]mL vs.[19.29±4.57]mL),the incidence of anastomotic leakage(8.3%vs.4.7%),the time of first anal exhaust([4.00±1.18]d vs.[3.79±1.18]d),the time of the first defecation([7.13±1.39]d vs.[7.63±1.38]d),and the length of postoperative hospital stay([11.29±1.94]d vs.[11.71±2.26]d)between the seromuscular layer anastomosis group and the two-layer anastomosis group were not statistically significant(P>0.05).While the anastomosis time of the seromuscular layer anastomosis group was(11.83±1.93)min,which was significantly shorter than that(21.29±1.94)min of the two-layer anastomosis group,and the difference was statistically significant(P<0.05).Conclusion The seromuscular layer anastomosis was safe and reliable in the colon anastomosis.

关 键 词：浆肌层吻合 二层吻合 结肠癌 腹腔镜 

分 类 号：R615[医药卫生—外科学]