生物可分解吻合环在结肠癌手术中的应用研究

Clinical study on biodegradable anastomosis ring used in colon operation

目的通过前瞻性研究,评价生物可分解吻合环(biaframentable anastomosis ring,BAR)在结肠癌手术中的临床应用价值。方法将我院69例结肠癌手术病人随机分成二组,其中应用BAR作肠吻合33例(BAR组);用传统手工吻合36例(TMA组)。对两组病人的平均手术和肠吻合时间、术后并发症,以及肠镜随访结果进行比较。结果两组病人均无死亡,均痊愈出院。BAR组的平均手术和肠吻合时间均明显少于TMA组;BAR组的术后并发症如吻合口出血、肠功能恢复时间、肺部感染均明显好于TMA组;BAR组无吻合口漏,而TMA组则有2例;3-6个月后的肠镜随访,结果显示在吻合口溃疡、吻合口炎、吻合口肉芽肿等方面BAR组均明显好于TMA组。两组上述多项指标的差异均有统计学意义(P<0.05或0.01)。结论应用BAR于结肠癌手术具有操作简便、快捷、疗效好及术后并发症少等优点。

Objective To valuate the biodegradable anastomosis ring （BAR） in colon carcinoma operation by means of prospective study. Methods 69 cases of colon carcinoma were randomly divided into two groups. Among them ,33 cases underwent intestine anastomosis with BAR in operation （ BAR group）, and another 36 cases underwent traditional manual anastomosis （TMA group）. The operation time for the intestinal anastomosis, the postoperative complication and the result of follow-up colonoscopy from the two groups were compared. Results There was no death in both groups after operation and all cases were cured to discharge from hospital. The operation time for intestinal anastomosis in BAR group was obviously shorter than that in TMA group. The postoperative complications such as anastomotic bleeding and pulmonary infection were obviously less in BAR group than that in TMA group. The period of bowel function recovery was shorter in BAR group than that in TMA group. There was no anastomotic leak in BAR group while two cases in TMA group. The foUow-up colonoscopy 3-6 months after operation showed the incidences of anastomotic stenosis, ulcer, inflammation and granuloma were obvioualy less in BAR group than that in TMA group. All the differences between the two groups mentioned above were statistically significant （P 〈 0. 01 or P 〈 0. 05）. Conclusions Application of BAR in colon cancer surgery has the advantages of simple,good efficiency and less postoperative complications.