国产KYGWA型一次性吻合器在贲门胃底癌中的应用

The application of China-made type KYGWA stapler in carcinoma of cardia and gastric fundus

目的探讨国产KYGWA型一次性吻合器在贲门胃底癌中的应用。方法统计1998年1月至2008年5月实行根治或姑息性手术的贲门胃底癌患者593例,其中应用吻合器217例(吻合器组),未用吻合器376例(手工组)。对两组的开胸率、吻合口瘘、肺部及胸腔感染、吻合口狭窄、近断端癌残留等方面的资料进行回顾性对比分析。结果吻合器组开胸率为21.66%,手工组为72.87%,吻合器组开胸率明显低于手工组,差异有统计学意义(P<0.05)。吻合器组吻合口狭窄发生率4.15%,手工组20.74%,两组比较差异有统计学意义(P<0.05)。两组在吻合口瘘、肺部及胸腔感染和近断端癌残留方面的差异无统计学意义。结论在贲门胃底癌切除术中利用国产一次性吻合器行消化道重建可以减少开胸率和吻合口狭窄发生率,且该吻合器价格低廉,具有临床应用价值,尤其适合经济欠发达地区医院的使用。

Objective To evaluate the application of China-made type KYGWA stapler in carcinoma of cardia and gastric fundus. Methods From January of 1998 to May of 2008, 593 cases with carcinoma of cardia and gastric fundus were performed with radical or palliative surgery. Those patients used stapler were regarded as stapler group and these not used stapler as manual group. The rate of open thoracotomy and some complications such as anastomotic leakage, pulmonary infection, anastomotic stenosis and positive proximate stump were analyzed retrospectively. Results The rate of open thoraeotomy was 21.66% in stapler group and 72.87% in manual group（ P 〈 0.05 ）. The rate of anastomotic stenosis was 4.15% in stapler group and 20.74% in manual group （P 〈 0.05 ）. Complications of anastomotic leakage, pulmonary infection, and positive proximate stump were no significant differences between these two groups. Conclusions The use of China-made stapler in resection of cardia and gastric fundus cancer can reduce the rates of open thoracotomy and anastomotic stenosis. Just for the excellent quality and reasonable price, China-made stapler is especially fit for those hospitals in poor areas.