胃肠外科吻合器应用相关并发症及其处理

Complications and treatment of stapled anastomosis for gastrointestinal surgery

吻合器已被广泛应用于胃肠外科消化道吻合重建当中。国外最新Meta分析显示:与手工缝合相比,机械吻合能显著缩短手术时间,降低并发症发生率,使病人获益,但是临床医生仍无法完全避免吻合器相关并发症的发生,而且并发症将给病人的预后带来不良影响。吻合口瘘、吻合口狭窄、吻合口出血为吻合器使用的重要并发症,外科医生必须对其提高认识,科学正确地预防及处理,同时应谨记机械吻合只是胃肠吻合的手段之一,并不能完全替代手工吻合。

Staplers have been used widely in anastomosis for gastrointestinal surgery. The recent meta-analysis showed that stapled anastomosis was associated with shorter operating time and lower incidences of complications than hand-sewn anastomosis, being beneficial for patients. However, doctors can not avoid anastomotie complications. Patients have worse prognosis with complications. Anastomotie leakage, stricture and bleeding are the main complications after stapled anastomosis. The definition, risk factors, prevention and treatment of three complications above should be introduced to the surgeons. Stapled anastomosis can＇ t replace the hand-sewn anastomosis completely.