目的 探討圓形吻合器在高齡賁門胃底癌經腹切除術中的應用。方法 回顧性分析1999年1月至2009年5月期間在我院接受圓形吻合器經腹切除術的238例70歲以上高齡賁門胃底癌患者的臨床資料，并對圍手術期結果進行分析。 結果 全組手術時間3～4.5 h，平均3.5 h。出血量50～1 000 ml，平均300 ml。術中并發大出血1例，給予積極止血，無術中死亡。所有病例機械吻合術后未出現吻合口漏。術后60例患者（25%）出現不同程度的并發癥，其中吻合口出血2例, 左側胸腔積液13例，肺部感染15例, 心衰3例, 肺不張2例, 心律失常10例，右側胸腔積液15例。無圍手術期死亡。術后隨訪3年，出現返流性食管炎45例，吻合口狹窄30例，無吻合口腫瘤復發，3年生存率為64%(152/238)。結論 應用圓形吻合器在高齡胃底賁門癌患者經腹切除術是安全、有效的。
目的 比較吻合器痔上黏膜環切術(PPH)與傳統痔切除術(Milligan-Morgan，MM)治療混合痔的臨床療效。方法 200例混合痔患者中行PPH和MM治療各100例，比較2組患者的療效及并發癥。結果 PPH在療效及術后并發癥發生方面與MM組比較，差異均無統計學意義（P＞0.05）。結論 在治療混合痔方面PPH不優于MM。
目的探討痔切除吻合器痔上粘膜環切術（PPH）的臨床應用價值。方法采用33 mm痔切除吻合器痔上粘膜切除術對嚴重脫垂性痔30例進行治療。結果全組病例平均手術時間10分鐘，術后住院時間1～3天，脫出痔塊均回縮，切除直腸粘膜完整率達98%，術后90%的患者無肛門疼痛，隨訪3個月，28例滿意，2例基本滿意。結論采用痔切除吻合器痔上粘膜環切術治療嚴重脫垂性痔是一種新技術，其手術操作簡單，具有安全、有效、手術時間短、術后疼痛輕、恢復快等特點，有望替代傳統的治療方法。
目的評價雙吻合器在中、低位直腸癌保肛手術應用中的安全性和實用性。方法分析 38 例應用雙吻合器行結、直腸吻合治療中、低位直腸癌的經驗。結果本組病例在使用雙吻合器中閉合和吻合過程順利、簡捷，術后無1 例發生吻合口漏; 發生吻合口狹窄1例,發生率為2.6%, 經肛門指法擴肛后即痊愈; 局部復發2例,復發率為5.3%。結論雙吻合器吻合法可作為中、低位直腸癌保肛手術的一種安全可靠的術式選擇。
目的 探討在局部麻醉下行痔上黏膜環形切除釘合術（procedure for prolapse and hemorrhoids，PPH）治療重度內痔的可行性及臨床應用價值。方法 筆者所在醫院科室從2005年起對32例Ⅲ度及Ⅳ度脫垂性內痔（含1例混合痔）患者均采用苯巴比妥＋氫溴酸東莨菪堿＋利多卡因肛管直腸環形局部浸潤麻醉行PPH術，對其麻醉效果、手術時間、術中及術后疼痛、尿潴留、術后感染、肛門狹窄、住院時間、治療滿意度等進行分析。結果 32例患者均順利完成手術，有1例術中改行低位連續硬膜外麻醉，1例輔加鎮靜劑及鎮痛劑。術后28例對疼痛能耐受，4例需鎮痛藥物；1例患者有肛門墜脹感；所有患者傷口均一期愈合，無尿潴留、術后感染、出血、肛門狹窄等并發癥發生；31例對療效滿意，有1例感肛門墜脹，行溫水坐浴及痔瘡膏納肛治療1周后緩解。住院時間3～6d，平均4d。32例患者均進行有效隨訪，隨訪時間2～4個月，平均3個月，無大便失禁或復發，肛門控便能力均可。結論 局部麻醉下行PPH術治療重度內痔是一種安全可行的手術方法，麻醉操作護理簡單，療效確切，術后并發癥少，術后恢復快，并可減少醫療費用。
目的 探討中低位直腸癌經全系膜切除（TME）并雙吻合器吻合術后吻合口的局部效果。方法 選取我院2004年3月至2008年6月期間收治的142例行TME并雙吻合器吻合術的中低位直腸癌患者的臨床資料進行回顧性分析。結果 所有病例手術操作均順利，術中無死亡。術后無吻合口漏等嚴重并發癥發生。吻合口狹窄發生率為6.3%（9/142）。術后24個月時局部復發率為7.6%（8/105）。結論 在中低位直腸癌治療中只要合理選擇病例、嚴格規范術中操作、術后積極觀察處理，TME并雙吻合器吻合術可以有效降低吻合口并發癥的發生。
目的 探討低位直腸癌雙吻合器保肛手術后吻合口漏的預防。 方法 回顧性分析2000年5月至2005年5月我院肛腸外科行雙吻合器保肛手術的78例低位直腸癌患者的資料。結果 所有病例應用雙吻合器進行直腸閉合并吻合成功,術后切緣病理檢查均未見癌細胞浸潤,無吻合口漏及手術死亡。隨訪73例(93.6%),隨訪時間9~65個月，平均35個月。盆腔復發2例(2.6%),腹腔廣泛轉移1例(1.3%),肝臟轉移7例(9.0%),吻合口局部復發1例（1.3%,術后11個月再次行Miles術）。結論 雙吻合技術為低位直腸癌患者提供更多的保肛機會,使用得當可有效預防吻合口漏的發生。
Objective To evaluate the safety and ascendancy of small caliber stapler application for anterior resection in ultra-low rectal cancer with anal sphincter preservation. Methods A retrospective analysis of the data of 60 cases of ultra-low rectal cancer treated by anterior resection with anal sphincter preservation by double stapling technique according to TME principle between June 2006 and June 2009 were undertaken. The 60 patients were divided into two groups, each group included 30 cases. One group adopted 33 mm stapler and another group adopted 29 mm stapler, and then the profiles of medi-operation, post-operation, and prognosis were assessed. Results Time of simple anastomose in operation was (9.0±3.3) min in 33 mm stapler group and (6.0±2.6) min in 29 mm stapler group, and there was significant difference between them (P=0.022 5). There were 6 cases needed to be restored because of lesion during operation or dys-anastomosis in 33 mm stapler group, while 2 cases in 29 mm stapler group, there was significant difference between them (P=0.030 1). No significant differences were observed between the two groups in terms of the time for operation, leakage, bleeding, stenosis, anastomotic recurrence, and fecal incontinence after operation or length of stay. Conclusion The application of 29 mm stapler not only can shorten time for anastomose and step down the degree of difficulty, but also dosen’t increase stenostomia and other complications.
ObjectiveTo compare the safety and efficacy of powered anastomosis versus mechanical anastomosis in gastrointestinal surgery. MethodsComputerized searches were conducted in PubMed, EMbase, Web of Science, CNKI, and CBM databases to collect studies comparing the safety and efficacy of powered versus mechanical anastomosis in gastrointestinal surgery. The search period was from the inception of each database to March 2025. Literature was screened according to inclusion and exclusion criteria, data were extracted, and the risk of bias was assessed. The quality of the included studies was evaluated using the Newcastle-Ottawa Scale (NOS). Meta-analysis was performed using the Metan package in Stata/MP 17.0 software. ResultsA total of 15 observational studies (13 retrospective and 2 prospective) involving 21,424 patients were finally included, with 9 823 patients in the experimental group (powered anastomosis) and 11 601 patients in the control group (mechanical anastomosis). The NOS scores of all included studies were ≥5 points. Meta-analysis results showed that, compared to the mechanical anastomosis group, the powered anastomosis group had significantly lower incidence rates of anastomotic leakage [RR=0.60, 95%CI (0.37, 0.96), P=0.031], postoperative complications [RR=0.68, 95%CI (0.53, 0.86), P<0.01], intraoperative bleeding rate [RR=0.29, 95%CI (0.15, 0.56), P<0.01], and 30-day readmission rate [RR=0.62, 95%CI (0.39, 0.97), P<0.05]. No statistically significant differences were found in anastomotic stenosis [RR=0.53, 95%CI (0.18, 1.57), P=0.25], intraoperative blood loss [SMD=?0.03, 95%CI (?0.15, 0.08), P=0.57], operation time [SMD=?0.00, 95%CI (?0.08, 0.07), P=0.90], or postoperative hospital stay [SMD=?0.05, 95%CI (?0.13, 0.02), P=0.15]. ConclusionIn gastrointestinal surgery, powered anastomosis may offer potential advantages over traditional mechanical anastomosis in improving the aforementioned safety and efficacy outcomes.