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目的探讨直线切割闭合器在远端胃窦癌根治Billroth Ⅰ式吻合术中的应用技巧及效果。方法选择2012年3月至2013年3月共30例行远端胃切除加Billroth Ⅰ式吻合术的胃窦癌患者,术中采用直线切割闭合器简化手术操作,并和同期采用常规方法治疗的40例患者对照,分析其临床资料及术后近期效果。结果观察组远端切缘长度为(3.8±1.2)cm,对照组为(3.3±1.3)cm,观察组切缘长度大于对照组(P=0.041);观察组吻合时间为(6.5±3.4)min,对照组为(16.0±4.5)min,观察组吻合时间小于对照组(P=0.037)。观察组术后腹腔及切口感染2例,对照组8例,观察组感染率小于对照组(P=0.044)。两组均无吻合口瘘病例。结论使用直线切割闭合器切断十二指肠球部、预置抵钉座在远端胃窦癌根治Billroth Ⅰ式吻合术中的应用能简化手术操作,缩短手术时间。
Objective To investigate the application skill and effect of linear incision closure in Billroth Ⅰ anastomosis of distal gastric cancer. Methods A total of 30 patients with gastric cancer who underwent distal gastrectomy and Billroth Ⅰ anastomosis between March 2012 and March 2013 were selected. The operation of linear incision closure was simplified during the operation. The patients were treated with routine methods 40 patients control, analysis of its clinical data and postoperative short-term results. Results The length of the distal margin of the observation group was (3.8 ± 1.2) cm and that of the control group was (3.3 ± 1.3) cm, and the length of the margin of the observation group was larger than that of the control group (P = 0.041) min in control group and (16.0 ± 4.5) min in control group. The anastomosis time in observation group was smaller than that in control group (P = 0.037). In the observation group, 2 cases were infected by abdominal cavity and incision postoperatively and 8 cases in the control group. The infection rate in the observation group was less than that in the control group (P = 0.044). There was no anastomotic leakage in both groups. Conclusions The use of a linear incision and closure device to cut the duodenal bulb and the use of a presetting abutment for Billroth Ⅰ anastomosis in distal anastomosis can simplify the operation and shorten the operation time.