Clinical and experimental study of end-to-side gastrojejunostomy with circular stapler after distal subtotal gastrectomy
10.3760/cma.j.issn.1671-0274.2007.z1.004
- VernacularTitle:胃次全切除后残胃-空肠端侧器械吻合的临床和实验研究
- Author:
Qin ZHANG
1
;
Zai-Yuan YE
;
Jian-Fa YU
;
Hong-Qi SHI
Author Information
1. 浙江中医药大学附属第一医院
- Keywords:
Subtotal gastrectomy;
Digestive tract reconstruction;
Stapler
- From:
Chinese Journal of Gastrointestinal Surgery
2007;10(z1):14-17
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study the clinical and experimental efficacy of end-to-side gastro jejunostomy with circular stapler after distal subtotal gastrectomy.Methods Twelve Beagle dogs were randomly divided into group A and B. End-to-side gastroduodenostomy was finished with circular staplers or hand-sewn after gastrectomy. Side-to-side gastroduodenostomy was done in the second operation after three months.Healing and diameter of end-to-side gastroduodenostomy in Beagle'S were observed dogs.Perimeter of side-to-side gastroduodenostomy and duodenum adjacent to anastomosis were measured. One hundred and forty-five patients suffered from stomach cancer were randomly divided into group A and B.Group A had 71 cases and Group B 74 cases.End-to-side gastrojejunostomy was finished with circular stapler or hand-sewn after distal subtotal gastrectomy.Leakage and stricture of anastomosis were observed after operation.Size of anastomosis and track of Barium fluid and gastric residual Barium fluids two hours later were observed one year after operation.Results All operations in 12 dogs were successful.Healing of anastomoses and triangles at small curvature were satisfied three months after operation.Diameters of end-to-side gastroduodenostomy in group A and B were (1.18±0.13)am and(1.20±0.09)cm respectively，which were not significantly different between the two groups(t=-0.255，P=0.804).Circumferences of side-to-side gastroduodenostomy and duodenum adjacent to anastomosis were(6.46±0.06)cm and(7.26±0.12)cm respectively.All operations in 106 cases were successful and no complications of leakage and stricture of anastomosis occurred.Thin Barium fluid passed over anastomosis quickly under X-ray after one year.There was a little Barium fluid in the residual stomach in two hours later. Conclusion End-to-side gastrojejunostomy with circular stapler after distal subtotal gastrectomy is feasible. Anastomosis at the original position of residual stomach ensures adequate remove of stomach and prevents from trauma of spleen and vessel around spleen.
