吻合术

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 positive rates of retrograde ureteropyelography,CT scanning,IVP,ultrasonography were86.7%、50%、12.5%、12.5%respectively.31of40cases were treated by total nephroureterectomy with segmental cystectomy,3cases by segˉmental ureterocystectomy with ureteroneocystostomy,2cases by segmental ureterectomy with end-to-end anastomoˉsis,2cases by single resection of tumor,2cases by resection of residual ureter with segmental cystectomy.

逆行输尿管插管造影、CT、IVP、B超检查的阳性率分别是86.7%、50%、12.5%、12.5%。40例患者中行患肾+全段输尿管+膀胱部分切除术31例，输尿管下段切除术+膀胱吻合术3例，输尿管肿瘤切除+输尿管端端吻合术2例，单纯输尿管肿瘤切除术2例。

Results Conservative treatment was carried out for 4 patients, ureteroureterostomy for 7 patients, ureteroneocystostomy for 22 patients, bladder valve-ureter anastomosis for 2 patients, vermiform appendix-ureter replacement for 2 patients, and nephrectomy for 1 patients.

结果 4例行双J管保守治疗，7例(9侧)行输尿管端端吻合术，2 2例行输尿管膀胱再植术，2例行膀胱壁瓣输尿管吻合术，2例行阑尾代右侧部分输尿管术，1例行肾切除术。

Three types of reconstruction procedures, including Orr-type Roux-en-Y esophagojejunostomy, P-type jejunal pouch Roux-en-Y esophagojejunostomy and distal jejunal aboral pouch Roux-en-Y esophagojejunostomy, were performed.

全胃切除后消化道重建分别采用全胃切除术后消化道重建Orr式Roux-en-Y食管空肠吻合术、P型空肠袢食管空肠Roux-en-Y吻合术和远端空肠反口贮袋的Roux-en-Y食管空肠吻合术。

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 Roux-Y hepaticocholangiojejunostomy were performed in 22 cases,hepaticocholangioduodenostomy with jejunum interposition in 2 and side to side choledochoduodenostomy in 1 case.

有22例施行肝胆肠空肠Roux-Y吻合术，2例施行肝胆管十二指肠间置空肠吻合术，仅1例施行胆总管十二指肠侧侧吻合术。

objective to investigate the clinical characteristics and the surgical treatment for perforation of gastric cancer.methods we summarized 22 cases suffering from perforation of gastric cancer in our hospital,6 were treated with repair of perforatlon and gastrojejunostomy at the same time,8 with partial gastrectomy,8 wth radical gastrectomy for gastric cancer（d2,d3）,and positive treatment such.as intraperitoneal chemothrapy to the patients above.results the life expectancy of patients treated with repair of perforation,partial gastrectomy or radical gastrectomy for gastric cancer was 6,29.2 and 37.3months.conclusion reasonably select surgery methoty and positive treatment are keys to prolong the survival time.

目的 探讨胃癌穿孔的临床特点及外科治疗方法。方法对22例胃癌穿孔病人实施不同手术方式治疗。其中行穿孔修补加胃肠吻合术6例，姑息性胃癌切除术8例，胃癌根治术（d2，d3）8例，后两者术后均行腹腔化疗等综合治疗。结果穿孔修补加胃肠吻合术、姑息性胃癌切除术、胃癌根治术术后平均生存期分别为6个月、29.2个月、37.3个月。结论合理选择术式，综合治疗，是延长病人生存期的关键。

Results Findings in the operation and pathologic diagnosis: gastric ulcer in 11 cases (50%); duodenal ulcer in 7 cases(33.9 %); Postbulbar duodenal ulcer in 1 case (4.5%); complexity ulcer in 3 cases(13.6%); among them, canceration in 2 cases (9.1%) Procedures: subtotal gastrectomy with Billroth 1 anastomosis in 6 cases(27.3%), subtotal gastrectomy with Billroth II anastomosis in 15 cases.

结果手术所见及病理诊断：胃溃疡11例(50％)；十二指肠球部溃疡7例(33.9％)；十二指肠球后溃疡1例(4.5％)；复合性溃疡3例(13.6％)；其中伴癌变2例(9.1％)。手术方式：胃大部切除Billroth 1式吻合术6例(27.3％)，胃大部切除BillrothⅡ式吻合术15例(68.2％)，全胃切除Roux—en—Y吻合术1例(4.5％)，其中溃疡旷置术3例(13.6％)。

Methods According to etiopathogenisis, 30 patients with obstructive azoospermatism were given vasovasostomy,vasoepididymostomy or vasovasostomy plus opposite vasoepididymostong,respectively.

对30例梗阻性无精子症患者，根据其病因分别采取输精管输精管吻合术、输精管附睾管吻合术、输精管输精管吻合术加对侧输精管附睾管吻合术。

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。