腹腔镜全胃切除术后食管空肠侧侧吻合术12例

A modified method of laparoscopic side-to-side esophagojejunal anastomosis after laparoscopic total gastrectomy：a report of 12 cases

目的总结腹腔镜全胃切除术后食管空肠重建的方法。方法总结分析自2006年2．10月间对12例胃癌患者采用腹腔镜直线切割器成功施行食管空肠侧侧吻合术的临床资料。结果全组患者吻合过程均顺利，手术时间（247．0±13．1）min，其中吻合耗时（43．5±10．4）min，术中出血量（107．5±44．9）ml，吻合121距肿瘤近端距离（3．4±1．2）cm，残端均无癌残留。无手术死亡及吻合口瘘发生，术后短期随访无吻合口狭窄。结论腹腔镜食管空肠侧侧吻合法是腹腔镜全胃切除后一种简单、安全、经济的消化道重建吻合方式。

Objective To explore the method of alimentary reconstruction after laparoscopic total gastectomy. Methods The clinical data of 12 patients undergone laparoscopic total gastrectomy and side-to-side esophagojejunal anastomosis from Feh. 2006 to Oct. 2006 were analyzed retrospectively. Results Laparoscopic side-to-side esophagojejunal anastomosis was successfully performed in 12 patients. The mean operation time was （247.0±13.1） min and the anastomosis time was （43.5±10.4） min. Bleeding volume during operation was （107.5±44.9）ml. The distance hetween anastomosis and proximal margin of tumor was （3.4±1.2）cm. There was no postoperative death, fistula or anastomotic stenosis occurred after short-term follow-up. Conculsion The modified laparoscopic side-to-side esophagojejunal anastomosis is a safe, less challenging and more economic method of alimentary reconstruction after laparoscopic total gastrectomy.