经口置入钉砧头系统在全腔镜下胃癌根治术消化道重建的应用

Oral implantation orvil in the nursing care of total laparoscopic radical resection of gastric cancer in the digestive tract reconstruction

目的:总结经口置入钉砧头系统(OrViL)在全腔镜下胃癌根治术中消化道重建的护理经验。方法:2012年8月～2013年2月我科利用OrViL全腔镜下胃癌根治术8例,术前充分评估患者的综合情况,术前3～5 d给口腔及食管清洁和杀菌,根据患者个体营养状况,给肠内营养或肠外营养。结果:8例患者均经口置入钉砧头系统(OrViL)在全腔镜下完成手术,无中转开腹。术后第1天患者就下床活动,术后5～6 d开始少量多次流质饮食,住院时间10～16 d,平均12 d。无吻合口并发症。结论:OrViL在全腔镜下胃癌根治术消化道重建术可有效代替传统开腹手术方法,避免留置胃管带来的极度不适及传统开腹带来的巨大创伤,具有创伤小、活动早、痛苦小、恢复快等优点,恰当的术前术后护理更有利于患者康复。

Objective：To summarize the nursing experience on digestive tract reconstruction by using the transorally inserted anvil （OrVi]） in total laparo- scopic radical gastrectumy. Methods：Our department used OrViL total laparoscopic gastrectomy eight cases from August 2012 to February 2013 ,preoperative fully assess the patient＇s situation,including the state of the economy,they were given psychological counseling respectively,3 -5 days before surgery, oral and esophageal cleanand sterilization,according to the individual patient nutritional status,to enteral nutrition or parenteral nutrition. Results：8 patients are placed through the transorally inserted anvil （OrVil） completed in total endoscopic surgery,without laparetomy. Patients on the first day after getting out of bed, postoperative 5 -6 days, started a small amount liquid diet, but many times,the average length of stay of 12 days （ 10 - 16 days）, anastomotic complica- tions. Conclusion ： OrViL in full laparoscopic gastrectumy reconstruction of the digestive tract can effectively replace the traditional open surgery method to a- void indwelling stomach tube extreme discomfort and brought huge traditional open trauma trauma as early activities, pain quick recovery, proper preoperative and postepemtive care is more conducive to the rehabilitation of patients.