完全腹腔镜Roux—en—Y吻合术式应用于远端胃癌根治术20例

lntracorporeal Roux-en-Y reconstruction after laparoscopic distal gastrectomy： a report of 20 cases

目的探讨完全腹腔镜Roux．en—Y吻合术式应用于远端胃癌根治术的安全性和可行性。方法回顾性分析福建省肿瘤医院腹部外科2012年8月至2013年3月对腹腔镜胃大部切除术后实施完全腹腔镜Roux．en—Y吻合术的20例胃癌患者的术中和术后临床资料。结果20例患者均成功实施完全腹腔镜远端胃癌根治术，无一例中转开腹或中转腹腔镜辅助手术。手术时间（190．8±53．6）min，术中出血量（122．4±57．7）ml，淋巴结清扫数（31．2±5．7）枚，术后病理切缘均为阴性。术后排气时间为（2．6±1．6）d，住院时间为（8．1±2．0）d。有1例术后出现肺部感染，但无吻合术相关并发症发生。结论完全腹腔镜Roux—en—Y吻合术式应用于远端胃癌根治术安全且可行。

Objective To investigate the safety and feasibility of intracorporeal Roux-en-Y reconstruction after laparoscopic distal gastrectomy. Methods Clinical data of 20 patients undergoing laparoscopic distal gastrectomy and intracorporeal Roux-en-Y reconstruction in our hospital from August 2012 to March 2013 were analyzed retrospectively. Results Totally laparoscopic distal gastrectomy was successfully performed in all the patients. The mean operation time was （190.8＋53.6） min, the mean operative blood loss was （122.4＋57.7） ml, and mean number of harvested lymph node was 31.2±5.7. Tumor-free proximal margin was confirmed by pathological examination in all the patients. The mean time to first flatus and hospital stay were （2.6±1.6） d and （8.1±2.0） d. One case developed pulmonary infection postoperatively, but no anastomosis related complication was observed. Conclusion lntracorporeal Roux-en-Y reconstruction after laparoscopic distal gastrectomy is safe and feasible.