贲门癌不同手术方式对术后吻合口并发症的影响:附156例报告
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The effect of different surgical procedures for cardia carcinoma on postoperative anastomotic stoma complications:a report of 156 cases
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    摘要:

    目的:探讨不同手术方式对贲门癌术后吻合口的影响。方法:对7年间收治的156例贲门周围癌患者,按所使用吻合器口径、手术和重建方式分组进行对比分析。结果:采用胸腹联合切口57例,经上腹正中切口68例,左侧直接进胸31例。胸腹联合切口组发生吻合口并发症4例(7.0%),经腹切口组发生吻合口并发症5例(7.4%),左侧进胸切口组发生吻合口并发症4例(12.9%) (P>0.05)。此外食管胃吻合口并发症发生率为8.7%,食管空肠吻合口并发症发生率为8.0%(P>0.05)。56例使用28 mm吻合器共发生9例吻合口并发症,发生率为16.1%;95例使用25 mm吻合器共发生4例吻合口并发症,发生率为4.2%(P=0.0102)。结论:在经济条件许可的情况下,尽量选择吻合器吻合可以降低手术后吻合口并发症的发生。选择正确的手术方式及使用25 mm口径吻合器的处理方法,可以降低此类患者吻合口并发症的发生率。

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    Objective:To investigate the effect of different operations for cardia carcinoma on the postoperative anastomotic stoma complications.Methods :Between December, 2000 and May, 2007,the clinical data 156 patients with carcinoma of gastric cardia who received different operations were analyzed retrospectively.Results:The thoracoabdominal incision was performed in 57 cases, abdominal incision in 68 and left thoracic incision in 31 cases.The occurrence rate of anastomotic stoma complications in the patients with thoracoabdominal,abdominal and left thoracic incision was 7.0%(4/57),7.4%(5/68),and 12.9%(4/31), respectively.The occurrence rate of anastomotic stoma complications in the patients using 25 mm endend autosuture was 4.2%(4/95), in using of the 28mm autosuture group was 16.1% (P=0.0102).Conclusions:The occurrence rate of anastomotic stoma complications can be reduced by choosing correct operation methods and using autosuture correctly.

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蒋春晖, 顾磊, 张斌, 徐庆, 罗蒙.贲门癌不同手术方式对术后吻合口并发症的影响:附156例报告[J].中国普通外科杂志,2008,17(11):18-112.
DOI:10.7659/j. issn.1005-6947.2008.11.018

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  • 在线发布日期: 2008-11-25