腹腔镜下胃切除术后消化道重建的操作技巧和注意事项

Technique of intracorporeai gastrointestinal anastomosis after total laparoscopic gastrectomy

胃的恶性和良性疾病是我国常见病．多发病．腹腔镜手术治疗这类疾病，是当代胃外科的一个显著标志．腹腔镜辅助胃癌根治术是其典型代表，也已被人们广泛认可和接受。腹腔镜下完成胃切除、淋巴清扫和消化道吻合重建的完全腹腔镜胃癌根治术。是对腹腔镜辅助胃癌根治手术的继承和发展，但因腹腔镜下消化道吻合的技术难度和风险，人们对其还有争论，完全腹腔镜胃癌根治术在中国和亚洲尚未得到广泛的发展。本文就腹腔镜下消化道吻合重建的历史与现状、技术和风险等相关问题，进行论述和讨论。

Malignant or benign diseases of stomach are very common in China. The application of laparoscopy surgery in gastric diseases is a remarkable symbol of current gastric surgery. Laparoscopic assisted radical gastrectomy has gained widespread acceptance for the treatment of gastric cancer. Total laparoscopic radical gastrectomy, which means the gastric resection, lymph nodes dissection and gastrointestinal anastomosis are entirely performed in intracorporeally, is the inheritance and progression of laparoscopic assisted radical gastrectomy. However, controversy still exists regarding the risk and difficulty of intracorporeal anastomosis. In Asian countries including China, total laparoscopic radical gastrectomy has not been extensively performed yet. This review focuses on the issues related to intracorporealgastrointestinal reconstruction in laparoseopic procedure, such as its history and current status, as well as the surgical technique and risk.