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目的 比较胃癌全胃切除术手法和机械重建消化道的手术时间、输血量、并发症及死亡率。方法 １９９３年１月至２０００年１２月我科共施行胃癌全胃切除术１４０例，按手法吻合和吻合器吻合重建消化道分为两组，手法吻合组５３例，吻合器吻合组８７例。两组的肿瘤部位、分期无明显差别。结果 手法组输血量为（４４３±４３２）ｍｌ，器械组为（４３０±４３５）耐（Ｐ＞０．０５）。手法组手术时间为（２５４±９５）ｍｉｎ，器械组为（２１１±５７）ｍｉｎ（Ｐ＜０．０５）。肺部感染手法组６例，器械组８例。切口感染手法组１例，器械组２例。吻合口狭窄两组各１例，吻合口瘘和术后出血手法组分别为２例和１例，器械组无吻合口痰和术后出血。手法组死亡１例，器械组无死亡。结论吻合器吻合重建消化道能节约手术时间，减少总手术并发症。
Objective To compare the operation time, blood transfusion volume, complications and mortality of total gastrectomy for gastric cancer and mechanical reconstruction of digestive tract. Methods From January 1993 to December 2000, 140 patients underwent total gastrectomy for gastric cancer. Digestive tract reconstruction with manual anastomosis and stapler anastomosis was divided into two groups: 53 cases with manual anastomosis group and 87 cases with stapled anastomosis group. There was no significant difference in tumor site and stage between the two groups. Results The amount of blood transfusion was (443±432)ml in the manual group and (430±435) in the instrument group (P>0.05). The operation time was (254±95) min in the manual group and (211±57) min in the instrument group (P<0.05). There were 6 cases of pulmonary infection and 8 cases of device. The incision infection group included 1 case and the instrument group 2 cases. Anastomotic stenosis occurred in one group and one case respectively. Anastomotic fistula and postoperative hemorrhage manipulation group were 2 cases and 1 case respectively. The device group had no anastomotic leakage and postoperative bleeding. There was one death in the manual group and no death in the device group. Conclusions Anastomosis and anastomosis can save the operation time and reduce the total operative complications.