자동문합기를 이용한 위전절제술 시 문합기 크기에 따른 합병증의 고찰
An Analysis of Complications according to Cartridge Size Following TotalGastrectomy with Roux-en-Y Esophagojejunostomy Using the EEA Stapler
홍정훈, 김호일, 김종석, 구범환,
소속 상세정보
홍정훈 ( Hong Jeong-Hun )
고려대학교 의과대학 외과학교실
김호일 ( Kim Ho-Il )
고려대학교 의과대학 외과학교실
김종석 ( Kim Chong-Suk )
고려대학교 의과대학 외과학교실
구범환 ( Koo Bum-Hwan )
고려대학교 의과대학 외과학교실
KMID : 0371320020620030205
Abstract
Purpose: Anastomotic stricture is one of the most common problems in
esophagojejunostomy using an end-to-end anastomosing (EEA) instrument
following total gastrectomy. Because anastomotic stricture often develops
with small- cartridge EEA, a larger EEA may be used to avoid stricture. The
purpose of this retrospective study is to evaluate the difference of
complications between patients treated using the EEA25 and ones using EEA28.
Methods: A total of 283 patients underwent curative total gastrectomy
and esophagojejunostomy with Roux-en-Y anastomosis, using EEA25 or EEA28,
between January 1992 and December 1999. The differences between the EEA25
and EEA28 groups were investigated by comparing them in terms of reflux
esophagitis, dysphagia, and stricture. Results: Stricture developed
in five patients (13.8%) in the EEA28 group and in 11 patients (4.45%) in
the EEA25 group (P<0.05), dysphagia was experienced less frequently in the
EEA25 than in the EEA28 group (P<0.05), and no significant differences were
evident with regards to reflux esophagitis. Conclusion: The choice of
a large EEA to avoid anastomotic stricture did not affect the development
of dysphagia or stricture. However, a randomized, prospective study should
be done to better define the relationship between the size of EEA and the
complications of total gastrectomy.
키워드
위암; 위전절제술; 단단 문합기; 합병증; Gastric cancer; Total gastrectomy; EEA stapler; Complication;
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