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首页> 外文期刊>Surgical Endoscopy >Anastomotic stenoses occurring after circular stapling in esophageal cancer surgery.
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Anastomotic stenoses occurring after circular stapling in esophageal cancer surgery.

机译：食管癌手术中圆形吻合术后发生吻合口狭窄。

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BACKGROUND: Circular staplers have reduced the incidence of anastomotic leaks in esophagovisceral anastomosis. However, the prevalence of stenosis is greater with staplers than with manual suturing. The aim of this study was to analyze potential risk factors for the onset of anastomotic stenoses and to evaluate their treatment and final outcome. METHODS: Between 1990 and 1995, 187 patients underwent esophagectomy and esophagogastrostomy with anastomosis performed inside the chest using a circular stapler. RESULTS: Twenty-three patients (12.3%) developed an anastomotic stenosis. The incidence of strictures was inversely related to the diameter of the stapler. Concomitant cardiovascular diseases; morphofunctional disorders of the tubulized stomach, such as those related to duodenogastric reflux; and neoadjuvant chemotherapy were also recognized as significant risk factors. Endoscopic dilatations proved safe and were effective in the treatment of most anastomotic stenoses. CONCLUSIONS: To reduce the risk of anastomotic stenosis after stapled intrathoracic esophagogastrostomy, adequate vascularization of the viscera being anastomized should be maintained, and it is mandatory to use the largest circular stapler suitable. Furthermore, it is essential to reduce the negative inflammation-inducing effects of duodenogastroesophageal reflux to a minimum. Endoscopic dilatations are safe and effective in curing the great majority of anastomotic stenoses.
机译：背景：圆形吻合器减少了食管内脏吻合术中吻合口漏的发生率。但是，与手工缝合相比，吻合器狭窄的患病率更高。这项研究的目的是分析吻合口狭窄的潜在危险因素，并评估其治疗和最终结果。方法：在1990年至1995年之间，有187例患者使用圆形缝合器在胸腔内进行了食管切除术和食管胃造口术，并在其内部进行了吻合术。结果：23例患者（12.3％）发生了吻合口狭窄。狭窄的发生与订书机的直径成反比。并发心血管疾病;输卵管胃的形态功能障碍，例如与十二指肠胃反流有关的疾病;和新辅助化疗也被认为是重要的危险因素。内窥镜扩张术被证明是安全的，并且对大多数吻合口狭窄都有效。结论：为减少经吻合胸腔内食管胃吻合术后吻合口狭窄的风险，应保持吻合的内脏血管充分血管化，并且必须使用合适的最大圆形吻合器。此外，必须将十二指肠胃食管反流的消极炎症诱导作用减至最小。内窥镜扩张术可安全有效地治愈绝大多数吻合口狭窄。

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