ENDO STITCH^(TM)自动缝合器在腹腔镜下4例食管癌空肠造口术中的应用

Laparoscopic jejunostomy with ENDO STITCH^(TM):Report of 4 cases of esophageal cancer

目的:探讨ENDO STITCH?自动缝合器用于腹腔镜下食管癌空肠造口术的可行性。方法:2010年11月-2011年1月,采用ENDO STITCH?自动缝合器为4例食管癌患者行腹腔镜下空肠造口术,其中3例患者为转移性食管癌伴吞咽困难,1例为接受全腔镜食管癌根治术患者而行空肠造口术。结果:4例患者均成功进行了空肠造口术,术中和术后均未发生严重的手术并发症。术后第1天即有肛门排气,可下床运动,术后24h开始肠内营养。术后随访结果显示,转移性食管癌患者在化疗期间均通过空肠造瘘管接受肠内营养,体质量基本保持稳定。结论:ENDO STITCH?自动缝合器应用于腹腔镜下空肠造口术是安全而可行的,适合体质较弱的食管癌患者的营养支持治疗。

Objective： To investigate the feasibility and safety of laparoscopic jejunostomy with ENDO STITCH^TM automatic suturing device for patients with esophageal cancer. Methods： From November 2010 to January 2011, four patients with esophageal cancer underwent laparoscopic jejunostomy with ENDO STITCH^TM automatic suturing device. Three patients presented with metastatic esophageal cancer and dysphagia. One patient underwent total laparoscopic and thoracoscopic esophagectomy for early esophageal cancer, with laparoscopic jejunostomy for post-operative nutrition support. Results： The laparoscopic jejunostomy was successfully performed with ENDO STITCH^TM automatic suturing device in 4 patients. No major complications were observed during and after operation. ALL patients resumed anal exsufflation and could be out of bed on the first day after operation. The enteral nutrition was administered 24 h after operation. During follow-up, patients with metastatic esophageal cancer all used jejunal feeding tube to receive enteral nutrition during chemotherapy, and the weight was maintained. Conclusion： Laparoscopic jejunostomy with ENDO STITCH^TM automatic suturing device is a safe and feasible technique. It is potentially accepted in patients with advanced esophageal cancer for nutrition support.