Objective To compare the effects of double stapling technique （DST） and single stapling technique （SST） in the low or ultralow anterior rectal resection and colon-anal canal anastomosis for patients with rectal cancer. Methods The clinical data of 351 patients with rectal caner， who were treated with low or ultralow anterior resection and colon-anal canal anastomosis in West China Hospital from Jan. 2009 to Dec. 2010， were collected and analyzed retrospectively. Operative and postoperative indexes of patients treated with DST （n=302） and SST （n=49） were compared. Results Compared with DST group， the distance from the dentate line to the edge of tumor， the length of the distal surgical margin 〔（1.83±0.59） cm vs. （2.07±0.56） cm〕， and hospitalization cost 〔（24 350.48±7 812.73） yuan vs.（29 455.32±7 869.33） yuan〕 of SST group were shorter or lower （P＜0.05）， but operative time was longer 〔（112.86±39.29） min vs. （100.10±36.75） min， P＜0.05〕. There were no significant differences on blood loss， duration of firstambulation， duration of first passing flatus， duration of first bowel movement， duration of pulling out nasogastric tube， duration of pulling out urinary catheter， duration of pulling out drain， postoperative hospital stay， total length of hospital stay， and the incidence of complication between the 2 groups （P＞0.05）. All patients were in functional recovery of anal control after operation. All patients were followed-up for 6-24 months （average 16 months）. During the followed-up， only 1 case suffered local tumor recurrence （SST group）， 3 cases suffered distant metastases （all in DST group）， and 15 cases （4.27％） died， of which 13 cases （4.30％） in DST group and 2 cases （4.08％） in SST group. Conclusions As in the low or ultralow anterior rectal resection and colon-anal canal anastomosis for patients with rectal cancer， SST results in shorter distal surgical margin than DST， so SST is suitable for the patients with shorter distance from the dentate line to the edge of tumor. What’s more， it saves the hospitalization cost effectively.
目的 研究胰腺-胃吻合术在胰十二指肠切除术消化道重建中的合理性。方法 对2002年3月至2004年10月期间实施胰十二指肠切除和胰腺-胃吻合术重建消化道的24例壶腹周围癌患者的临床资料进行回顾性分析。结果 所有患者均顺利完成胰腺-胃吻合手术，胰瘘的发生率为8.3%（2/24），通过保守治疗均痊愈。结论 胰腺-胃吻合术是胰十二指肠切除术后一种安全的消化道重建方法。
目的:探讨鼻内窥镜在泪囊鼻腔吻合术后的应用。方法:343例436眼实施泪囊鼻腔吻合术,术后结合鼻内窥镜检查。结果:术后随访1～12月,手术治愈好转率为96.33%。结论:鼻内窥镜对泪囊鼻腔吻合术后吻合口行检查及修复,能很好的提高泪囊鼻腔吻合术成功率。
目的为提高胆总管囊肿切除、胆肠RouxY吻合术的疗效，对其影响疗效的相关因素进行经验总结。方法对我院收治的34例小儿先天性胆总管囊肿进行回顾性分析。结果31例施行了手术，术后随访通过B超、X线胃肠钡餐检查表明30例治愈，疗效满意，1例新生儿术后并发吻合口漏死亡。手术治愈率96.8%，手术死亡率3.2%。结论为提高本术式的疗效，术前的B超、CT扫描以及术中的胆道造影，ERCP检查对判定本病类型，有无胰胆管合流异常，对选择手术方法和疗效有帮助，此外注意囊肿的病理改变及手术技术对提高疗效，减少并发症的发生也是十分重要的。