腹腔镜下远端胃癌根治术中三角吻合技术的运用

Application of delta-shaped anastomosis in totally laparoscopic distal gastrectomy

目的：观察腹腔镜下远端胃癌根治术中三角吻合术的可行性、安全性。方法回顾性分析9例采用腹腔镜下远端胃癌根治（D2）＋三角吻合术患者的临床资料。结果9例患者均顺利完成手术，手术时间（178±43）min，三角吻合时间（32±8）min。术后病理检查远、近切缘均阴性，淋巴结清扫数目（27±8）枚／例。术后肠道功能恢复时间（3．8±1．7）d，进食流质时间（3．9±1．8）d。术后1例患者出现脐部切口脂肪液化，1例出现尿路感染，无吻合口瘘、吻合口出血、吻合口狭窄等并发症发生。结论三角吻合术安全、操作方便，是进行腹腔镜远端胃切除术术后重建的可靠的吻合方式。

Objective To observe the technical feasibility and safety of delta -shaped （DS）anastomosis in totally laparoscopic distal gastrectomy （TLDG）.Methods A retrospective analysis of 9 cases underwent TLDG with D2 lymphadenectomy and DS anastomosis.Results All the patients underwent TLDG with D2 lymphadenectomy and DS anastomosis successfully by the same doctor and his team.The total operative time was （178 ±43）minutes,and the DS anastomosis time was （32 ±8）minutes.All the patients achieved microscopic cancer -free margin and the number of lymph nodes harvested was （27 ±8）per patient.The average time to flatus,time to fluid diet were （3.8 ± 1.7）days and （3.9 ±1.8）days respectivly.One patient developed to fat liquefaction of incision,and one developed to urinary tract infection after the operation.No anastomotic bleeding,anastomotic leakage,anastomotic stenosis or other anastomotic complications happened among all patients.Conclusion DS anastomosis is safe and convenient.It is an ideal choice for reconstruction in TLDG with D2 lymphadenectomy.