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食管癌和贲门癌切除食管胃肠线吻合的临床观察 被引量:4

THE CLINICAL OBSERVATION OF USING CATGUT SUTURE TO MAKE ANASTOMOSIS AFTER RESECTION OF ESOPHAGEAL CARCINOMA AND GASTRIC CARDIA CANCER
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摘要 目的 通过食管胃肠线吻合术后内镜观察,证明肠线是食管胃内层缝合的理想材料.方法 随机采用“000”羊肠线(A组)和丝线(B组)施行食管癌和贲门癌切除食管胃吻合各200例.结果 两组术后并发症发生率和手术死亡率无差异,A组进普食顺利者较B组明显增多,而食管胃吻合口瘘的发生率却比B组低.术后食管造影示:逆蠕动、吻合口残留钡剂,残食管扩张和吻合口狭窄的发生率A组较B组明显降低,而且肠线缝合Ⅰ期愈合率较丝线缝合高,说明丝线长期残留是促进纤维组织增生、造成吻合口狭窄的重要原因.结论“000”肠线容易吸收,价格便宜,对组织刺激小,反应轻,吻合口愈合快,能够降低食管胃吻合口狭窄和食管胃吻合口瘘的发生率,是食管癌和贲门癌切除食管胃内层缝合的理想材料. PURPOSE To analyse the advantages of using catgut suture in esophageal careinoma and gastric cardia cancer. METHODS From Dec. 1, 1993 to Dec. 1995 the authors adopted two sorts of sutures to do anastomosis after resection in esophageal and gastric cardia cnacer. There were 200 cases randomized to the '000' catgut suture (group A) and 200 to the silk suture (group B). RESULTS Statistics showed that there were no complication and overall mortality rates between the two groups (P>0. 05). More patients in Group A could swallow normal diet than group B (P<0. 01). Thus leakage was lower than group B. The esophagography showed that reversed peristalsis of esophagus, remaining barium, enlargement of the remaining esophagus and anastomotic constriction was distinctly decreased in group A(P<0. 05-0. 01). The primary healing rate in group A was higher than group B. This shows that the retaining of the silk suture could stimulate fibrous tissue hyperplasia. delay the healing and it may be the main cause of the constriction. CONCLUSION The results proposed that the '000' catgut suture can be absorbed easily, is less expensive, had less stimulation to the tissue and increase healing rate . and decrease the occurrence of constriction and leakage thus it is an ideal suture for esophagogastrotomy.
出处 《中国癌症杂志》 CAS CSCD 1998年第1期6-7,11,共3页 China Oncology
关键词 食管肿瘤 贲门癌 吻合术 肠线 Esophageal and gastric cardia cancer Anastomosis Catgut suture
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参考文献5

  • 1智会先 曹景峰 韩孝存 等.食管、贲门癌切除食管胃肠线吻合术后内镜观察[J].中国肿瘤临床,1994,:31-31.
  • 2卫功铨,邵令方,高宗人,许金良,陈明跃,王文光,程金华.食管重建术后吻合口狭窄的扩张治疗[J].中华外科杂志,1994,32(12):753-754. 被引量:27
  • 3Orringor MB, Marshall B, Stirling MC, et al. Transhiatal-esophagectomy for benign and malignant disease. Cardiovase Surg,1993,105;265.
  • 4Winkle WV. Effort of suture materials on healing skin wounds.Gynecol Obstet,1975,7:140.
  • 5陈英洋.丝线缝合胃肠道不良效果的实验研究[J].中华外科杂志,1984,22:84-84.

二级参考文献2

  • 1鲁平,中华外科杂志,1985年,2卷,93页
  • 2邵令方,食管外科学,1987年

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