食管胃手术中食管胃与胃肠吻合的缝合技术

Т. Amanov
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引用次数: 0

摘要

相关性:在西哈萨克斯坦地区(WKR),食管癌发病率排名第4,胃癌发病率排名第3。2019-2021年,平均每年确诊80-120例,其中40-50例接受手术治疗。本研究旨在通过减少术后吻合失败等并发症,减少术中时间,评价所提出的改进吻合口缝合方法的有效性,提高手术效果。方法:2019-2021年,在西哈萨克斯坦地区肿瘤药房(哈萨克斯坦乌拉尔斯克)行食管胃手术150例,其中Lewis手术76例,Garlock手术29例,扩大胃切除术45例。根据M.I. Davydov的方法,标准的缝合技术包括四个阶段,包括16针的强制缝合。在建议的版本中,使用了一种改进的技术,包括3个步骤,而不形成第二排前唇吻合缝合线。根据以下标准对结果进行评价:a)与标准方法相比,吻合失败的病例数;B)术中持续时间。结果:改进后的食管胃吻合和食管肠吻合技术减少了术后并发症的发生。因此,从2019年到2021年,术后并发症从8.1%下降到3.9%。结论:本文提出的食管胃、食管肠吻合技术在食管胃疾病患者手术中应用的有效性和实用性已得到证实。
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SUTURING TECHNIQUE FOR ESOPHAGOGASTRIC AND GASTROENTEROANASTOMOSIS DURING OPERATIONS ON THE ESOPHAGUS AND STOMACH
Relevance: Esophageal cancer is in 4th place, and gastric cancer is in 3rd place in terms of cancer incidence in the West Kazakhstan region (WKR). In 2019-2021, an average of 80-120 patients had identified annually, of which 40-50 patients underwent surgical treatment. The study aimed to evaluate the effectiveness of the proposed improved method of suturing the anastomosis and enhancing the results of surgery by reducing postoperative complications in the form of anastomosis failure and reducing the time of the intra-operative period. Methods: In 2019-2021, 150 operations on the esophagus and stomach were performed in the Regional Oncological Dispensary of the West Kazakhstan Region (Uralsk, Kazakhstan) in the amount of Lewis operation – 76, Garlock operation – 29, extended gastrectomy – 45. According to the method of M.I. Davydov, the standard technique of suturing includes four stages and involves the imposition of 16 stitches. In the proposed version, an improved technique consisting of 3 steps is used without forming the second row of anterior lip anastomosis sutures. The results were evaluated according to the following criteria: a) the number of cases of anastomosis failure compared to the standard procedure; b) the duration of the intraoperative period. Results: Using an improved technique for applying esophagogastric and esophago-intestinal anastomosis has reduced the number of postoperative complications. So, from 2019-2021, postoperative complications decreased from 8.1% to 3.9%. Conclusion: The effectiveness and practicality of the proposed technique of applying esophagogastric and esophago-intestinal anastomosis during operations in patients with diseases of the esophagus and stomach have been proven.
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