- 期刊
EEA型自動縫合器吻合後發生漏泄之原因─196例直腸癌手術病例分析─
Postoperative Leakage of Rectal Cancer after EEA Stapled Anastomoses ─ Analysis of 196 Cases─
摘要
腸管自動縫合器（EEA）發展至今已有它的安全性及可靠性，但是術後發生吻合處漏泄的合併症亦無法避免的，本院自一九八三年一月起，五年期間連續共有196例原發性直腸癌接受EEA作吻合術，其手術情形符合下列條件者被提出本本分析材料：一、經腹部作腫瘤切除同時使用EEA型自動縫合器作腸吻合術。二、無近端保護性腸造口而且以前從未接受過任何手術治療。經觀察結果，手術中即發現吻合處漏泄有十一例（5.6%）再予以修補，手術後數週發生吻合處漏泄有七例（3.6%），其中五例在手術中即被認為不完整切除環，另二例為完整切除環之完善吻合手術，此七例中有一例因此種漏泄合併症而死亡，其餘經治療後痊癒。經分析以EEA吻合術發生吻合處漏泄合併症與手術失血量、腫瘤位置、手術方法、切除環完整性及手術中漏泄等因素有關。
關鍵字
無資料並列摘要
A retrospective analysis was conducted in 196 consecutive patients who received restorative resection for rectal cancer with EEA stapled anastomoses between 1983 and 1987, and with no proximal protective colostomy or any previous surgical treatment. The data of each case, including age、 sex、 body weight、 tumor location、 operative time and blood loss, were analyzed statistically between postoperative leakage group and the non-leakage group. The details of EEA instrumentation included the completeness of donut tissue、 presentation of intraoperative leakage and hand-sewn anastomotic repairement. There were three (1.5%) cases of operative mortality. The anastomosis-related complications were 13 cases of imperfect EEA donut, eleven cases of intraoperative leakage and seven cases of postoperative leakage. Significant differences were found between the two groups, as shown by the Mean-Whitney U test and Chi-square test, in blood loss、 tumor location、 operative method and instrumentation of EEA stapler.