管型吻合器在上消化道重建中的应用(附89例报告)

Application of Tube-Type Anastomat in the Reconstruction of Upper Digestive Tract:A Report of 89 Cases

目的 探讨应用管型吻合器重建消化道的效果。方法 行全胃或胃大部切除后 ,在预定两吻合口之间切开近端空肠 ,置入吻合器行空肠侧侧、食管 空肠或残胃 空肠一次性吻合 ,缝合缩窄切口部肠管。结果 术后未见吻合口瘘、狭窄、出血、排空障碍等并发症 ,随访 3～ 6个月 ,无食管或残胃区疼痛 ,无呕吐等。结论 此法操作简单易掌握 ,行食管空肠吻合时更显其优点 ,保证了空肠的连续性 ,缝扎缩窄空肠可阻止十二指肠液向上逆流 ,达到Roux en Y式效应。

Objective To evaluate the effect of tube-type anastomat on the reconstruction of upper digestive tract.Method After total or subtotal gastrectomy,the proximal jejunum was excided between two scheduled stomas,the tube-type anastomat was placed,then side-to-side intestinal,oesophagus-jejunum or gastric renmant-jejunum anastomosis was performed,and the intestinal tract in contracted incision was sutured.Results No complications such as stoma fistula,stenosis,bleeding and emptying obstruction occurred after the operation.Pain in esophago and gastric remnant and vomiting were not found during 3～6 months follow-up.Conclusions The method is simple and easy to control,especially in oesophagus-jejunmu anastomosis,which not only maintains the continuity of jejunmu,but also prevents the regurgiation of duodenal and produce the effect of Roux-en-Y.