吻合

Abstract］ objective to discuss the influencing factors of healing up of anastomosis between traditional and morden ideas and question the more reasonable method of intestinal tract preparation in stage one operation.methods twenty-six patients with colon cancer were divided into 3 groups:colostomy group（8 cases）,washing group (9 cases) and suction group (9 cases).all the patients underwent colectomy plus stage one anastomosis and exteriorization with different interoperative preparation with which we compared the healing up of anastomosis within the three groups.results there were 3 cases having fistula in the colostomy group （8 cases）;one case in the washing group,but all the patients in the suction groups gained stage one healing up.conclusion as a method of emergency interoperative peparation,stool suction has a better healing up of anastomosis than colostomy and washing;it is advantageous to observe the healing up of anastomosis through colectomy plus stage one anastomosis and colon-outlying.

目的 探讨影响吻合口愈合因素的传统与现代观念并进一步探讨一期手术中更为合理的肠道准备方式。方法 26例降结肠癌分为造瘘组（8例）、冲洗组（9例）和粪便吸引组（9例）三组，术中分别采用3种不同方式行紧急肠道准备，所有病人均采用结肠切除一期吻合加外置的方法，对比观察三组病人的吻合口愈合情况。结果造瘘组（8例）有3例发生瘘，冲洗组有1例发生瘘，粪便吸引组全部一期愈合。结论粪便吸引作为一种术中紧急肠道准备方法，其吻合口愈合情况优于前两组；结肠一期吻合加外置的方法有利于观察吻合口的情况。

The average age was 27.8 years, and there were 47.5% patients with malignant change, the average age of them was 35.9 years. The choice of operative procedures included total proctocolectomy with ileostomy in 60 cases (26.0%), subtotal colectomy+rectal polyposis electrocautery in 63 cases (27.3%), total colectomy or proetocolectomy with ileo-anal anastomosis in 12 cases (5.2%), total colectomy or proctocolertomy with ileal pouch-anal anastomosis in 19 cases (8.2%), subtotal colectomy+rectal mucoscctorny, through the muscular sheath of rectum ileo-anal anastomosis in 22 cases (9.5%), ileal pouch-anal anastomosis in 47 cases (20.3%), and subtotal proctoeoleetomy in 8 cases (3.5%).

术式选择全结肠直肠切除＋末端回肠腹壁造口术60例(26.0%)，全结肠部分直肠切除＋回肠直肠吻合术63例(27.3%)，全结肠直肠切除＋回肠肛管吻合术12例(5.2%)，全结肠直肠切除＋回肠储袋肛管吻合术19例(8.2%)，全结肠部分直肠切除＋残留直肠黏膜剥脱＋经直肠肌鞘回肠肛管吻合术22例(9.5%)，全结肠部分直肠切除＋残留直肠黏膜剥脱＋经直肠肌鞘回肠储袋肛管吻合术47例(20.3%)，部分结肠或直肠切除术8例(3.5%)。

Methods:clinical data of 23 cases of left-sided colonic carcinoma undergoing one-stage resection and primary anastomosis were analyzed respectively.intraoperative colonic lavage were performed in all cases.for the 14 cases which were considered to be dangerous,preventive ceostomy was performed.results:23 cases were performed one-stage resection and primary anastomosis,all patients had not any complications such as anastomatic leakage and infection of the peritoneal cavity.conclusions:have a strict control over operation indication,perform postoperative care properly, one-stage resection and primary anastomosis for acute obstruction of left hemicolonic carcinoma is safe and workable.

回顾性分析我院五年来23例左半结肠癌并急性梗阻一期切除吻合术的临床资料，所有病例均术中结肠灌洗，而认为有危险性的14例同时行预防性盲肠造瘘。结果：23例一期切除吻合术，无一例发生吻合口漏、腹腔感染等并发症。结论：严格掌握手术适应症，积极术前准备，充分结肠灌洗，对认为有危险性吻合口实行预防性盲肠造瘘，正确术后处理，左半结肠癌并急性梗阻一期切除吻合术是安全可行的。

The case number of duodenopancreatectomy,cholecystojejunostomy, cholecystoduodenostomy, gastrojejunostomy, cholecystostomy, choledochoduodenostomy, choledochjejunalostomy, exploration of the common bile duct, and T tube drain were 43, 20, 3, 19, 4, 4, 21, 18, 7 respectively.

行胰十二指肠切除术43例，胆囊空肠吻合术20例，胆囊十二指肠吻合术3例，胃空肠吻合术19例，胆囊造瘘术4例，胆总管十二指肠吻合术4例，胆总管空肠吻合术21例，胆总管探查、T管引流18例，剖腹探查术7例。

The BJ patients were subdivided into cholecystojejunostomy group (n=56) choledochojejunostomy group (n=330), gastrojejunostomy group (n=32) and no-gastrojejunostomy group (n=57) according to the different methods of anastomosis.

BJ组根据吻合方式再分为胆囊空肠吻合组（56例），胆管空肠吻合组（33例）；是否附加胃空肠吻合又分为BJ+胃空肠吻合组（32例），BJ未附加胃空肠吻合组（57例）。

The BJ patients were subdivided into cholecystojejunostomy group(n=56)、 choledochojejunostomy group(n=33), gastrojejunostomy group(n=32) and no-gastrojejunostomy group(n=57) according to the differen methods of anastomosis.

BJ组根据吻合方式再分为胆囊空肠吻合组(56例)，胆管空肠吻合组(33例)；是否附加胃空肠吻合又分为BJ+胃空肠吻合组(32例)，BJ未附加胃空肠吻合组(57例)。

Methods:The incisional infection rates between the manual way (43 cases) in March 1998 and the anastomat way (59 cases) in March 2006 in the esophagogastrostomy after resection fo esophageal carcinoma were compared.

回顾分析我院1998年3月手工吻合43例与2006年3月器械吻合59例病人行食管癌切除食管胃吻合术，比较器械吻合组和手工吻合组术后切口感染率的发生。

objective to discuss treatment of acute perforation of peptic ulcer,to elevate i stage operation recovery rate.methods 208 cases in 20 years were retrospectively analysed,86 cases (41.35%) were recovered by subtotal gastrectomy;18 cases (20.93%) were undergone billroth i anastomosis;68 cases (79.07%) billroth ⅱ;42 cases (61.76%) billroth ⅱ precolonic anastomosis;26 cases (38.24%) retrocolic anastomosis.results in 86 cases,1 case was complicated by gastroparesis,others all recovered.all cases were followed up for 5 years.conclusion the procedure can shorten the recovery time and increase quality of life.

目的 探讨消化性溃疡急性穿孔的治疗方法，旨在提高ⅰ期手术治愈的成功率。方法回顾性总结分析20年间手术治疗消化性溃疡急性穿孔208例，其中86例（41.35%）采用胃大部连同病灶切除ⅰ期治愈，胃肠重建采用billrothⅰ式吻合18例（20.93%），billrothⅱ式吻合68例（79.07%），billrothⅱ式结肠前吻合42例（61.76%），结肠后吻合26例（38.24%）。结果 86例中除1例billrothⅱ式吻合术后发生胃瘫并发症，经保守治疗月余治愈外，其余病例术后恢复顺利，均随访5年以上情况良好。结论消化性溃疡急性穿孔的ⅰ期手术治疗，解决了因溃疡穿孔单行修补术后再次复发穿孔、出血、幽门梗阻、粘连、溃疡恶变而重复手术等问题，缩短了治愈周期，提高了生存质量。

Methods Forty patients with hepatobiliary and pancreatic diseases undergoing biliojejunostomy or cystojejunostomy were randomly divided into seromuscular layer anastomosis group (n=20) and two-layer anastomosis group (n=20) before operation, which received Roux-en-Y end-to-side jejunal seromuscular layer anastomosis and two-layer anastomosis, respectively.

行胆管空肠Roux-en-Y吻合的患者随机分成2组：浆肌层吻合组(n=20)和二层吻合组(n=20)，浆肌层吻合组行Roux-en-Y袢处空肠－空肠浆肌层吻合，二层吻合组行Roux-en-Y袢处空肠－空肠二层吻合。

Methods Resection and anastomoses of the small bowel at normal or at peritonitis was performed in rats.

大鼠分别在正常腹腔条件和腹腔感染条件下分五组实验，分别为：标准吻合组（丝线吻合12针）、简易吻合组（丝线吻合4针）、简易吻合+FG组、简易吻合+GH组、简易吻合+FG+GH组。

On closer examination, though, this is not a vote for multilateralism but just the opposite.

仔细审视后我们发现，这并非是对多边主义投出的赞成票，而是恰好相反。

Uncovering their weak spots, so I can defeat them.

揭露出他们的弱点，这样我就可以打败他们了。