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頁籤選單縮合
題名 | Experience with the Use of the Circular Stapler in Rectal Surgery=環狀自動吻合器用於直腸手術的經驗 |
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作者姓名(中文) | 金臺明; 簡立建; 趙東波; 蔡宗志; 王瑞和; 梁長齡; | 書刊名 | 中華民國大腸直腸外科醫學會雜誌 |
卷期 | 9:1 1998.03[民87.03] |
頁次 | 頁1-7 |
分類號 | 416.245 |
關鍵詞 | 自動吻合器; 直腸手術; Circular stapler; Anastomosis; Colorectal resection; Leakage rate; |
語文 | 英文(English) |
中文摘要 | 自動吻合器應用於大腸直腸外科手術,其價值與功能已受到肯定。從1991年1月到1995年12月,共有245位病患在切除直腸或乙狀結腸病灶後使用環狀自動吻合器接合腸道。病患的年齡範圍是32-38歲,男性192人,女性53人。手術的適應症主要是惡性腫瘤,以及小部份的憩室疾病和絨毛腺瘤。手術的死亡率是1.2%(3人),其中一人是因吻合隙漏造成。手術後的併發症主要是吻合隙漏,有13人。吻合處狹窄有6人,但只有2人有症狀;用直腸鏡擴張及經直腸疤痕切開治療後,症狀都消失。有21人在施行自動吻合器操作時有某些程度的困難,但經適當的處理後,都能有良好的結果。19人(7.8%)做了預防性大腸造口以保護吻合處的安全。使用自動腸道吻合器可以幫助腸道吻合的施行,尤其是在狹窄的骨盆,解剖位置困難的個案。手術後的併發症低,多數的病人不必做預防性大腸造口。年輕資淺經驗較少的醫師,短時間內即可學會操作的技巧。隨著經驗的累積,操作更熟練後,手術時間及併發症會再減少。 |
英文摘要 | Stapled anastomoses are currently an established technique in colorectal surgery. We evaluated the morbidity, clinical leakage rate, and mortality in an unselected population of a teaching hospital with the use of the circular stapler for construction of anastomoses following resection, a series of 245 anastomoses performed was reviewed. The patients ranged in age from 32 to 88 years. There were 192 men and 53 women. Indications for operation included malignancy, diverticular disease, and villous adenoma. The anastomosis was performed in a uniform manner with the EEA (United States Surgical Corp., Norwalk, CT). The operative mortality was 1.2 percent, with one death being related to the anastomotic leakage. Early postoperative complications included 13 leaks and a number of complications unrelated to the anastomoses. Anastomotic stenosis developed in 6 patients, but only 2 of these were symptomatic. They were treated with transrectal incision of scarring and scope dilatation. Use of the stapling technique facilitates the performance of anastomoses, particularly in the regions with difficulty anatomy. The rate of local complications in low, and protective colostomy can thus be dispensed with in most cases. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。