消化道单层与双层吻合术的临床比较:附2062例报告

Comparison of the effect of single-layer anastomosis with double-layer anastomosis of digestive tract: a report of 2 062 cases

目的 评价单层吻合在消化道手术中的临床应用价值。方法 回顾性分析 160 0例单层吻合术与 462例双层吻合的临床资料。结果 2 0 62例手术均顺利完成。单层吻合发生吻合口漏2 5例 ( 1.5 6% ) ,吻合口狭窄 3例 ( 0 .19% ) ;双层吻合发生吻合口漏 8例 ( 1.73 % ) ,吻合口狭窄 6例( 1.2 9% )。两种术式的吻合口漏发生率差异无显著性 (P >0 .0 5 ) ;但吻合口狭窄的发生率则单层较双层明显减少 (P <0 .0 1)。两种吻合术均无吻合口大出血。结论 单层吻合不增加吻合口漏的发生率 ,并能减少吻合口狭窄梗阻 ,系一安全、可靠、有效的吻合方法。

Objective To evaluate the clinical value of single-layer anastomosis(SLA) in the digestive tract operation. Methods The clinical date of 1 600 cases of SLA and 462 of double-layer anastomosis(DLA) were analyzed. Results The operations on all the 2 062 patiens were performed successfully. The leakage happened in single-layer anastomosis was in 25 (1.56%) cases and stenosis in 3 (0.19%) ; while the leakage happened in double-layer anastomosis was in 8 (1.73%) cases and stenosis in 6 (1.29%). The difference of anastomotic leakage rates between the two methods was not significant (P>0.05), but the stenosis rate of the single-layer anastomosis was obviously lower than that of the double-layer anastomosis (P<0.01).No anastomotic bleeding developed in all the patients. Conclusions Single-layer anastomosis can not increase the anastomotic leakage rate, but can decrease the anastomotic stennsis and obstruction. It′s a safe, practical and efficient anastomotic method.