全腹腔镜远端胃癌根治术胃空肠Roux-en-Y吻合的临床应用

Application of Roux-en-Y anastomosis in totally laparoscopic distal gastrectomy

目的介绍全腹腔镜远端胃癌根治术后采用胃空肠Roux-en-Y吻合进行消化道重建的手术方式。方法回顾性总结10例远端胃癌患者施行全腹腔镜下远端胃癌根治术后采用胃空肠Roux-en-Y吻合的消化道重建方式的具体手术方法和术后恢复情况。结果 10例患者均完成全腹腔镜下Roux-en-Y重建,出血量为(57.0±19.5)ml,消化道重建时间(48.0±15.3)分钟,术后患者胃管拔除时间为(4.4±0.7)天,术后住院时间为(8.0±1.2)天,平均清扫淋巴结(27.5±4.7)枚,下切缘距病变距离为(3.0±0.6)cm,上切缘距病变距离为(4.9±0.8)cm,未发生手术相关并发症。结论全腹腔镜下采用胃空肠Roux-en-Y吻合的重建方式操作简便,安全有效,术后并发症少,患者生活质量高,是一种理想的全腹腔镜胃癌手术方式。

Objective To introduce the surgical method of Roux-en-Y anastomosis in totally laparoscopic distal gastrectomy（TLDG）. Method Retrospectively analyzed the surgical technique and postoperative recovery of 10 distal gastric cancer patients who received TLDG with Roux-en-Y anastomosis. Result TLDG and Roux-en-Y anastomosis were completed successfully in all 10 patients. The average blood loss was（57.0±19.5） ml;the average time of anastomosis was（48.0±15.3） minutes. The average of stomach tube removal time was（4.4±0.7） days, and the length of hospital stay after operation was（8.0±1.2） days. The average number of dissected lymph nodes was（27.5±4.7）, the distance from lesion to lower margin was（3.0±0.6） cm, from lesion to upper margin was（4.9±0.8） cm. No surgeryrelated complications happened. Conclusion The TLDG with Roux-en-Y anastomosis was safe and effective. It was an ideal anastomosis method for TLDG, with less complications and higher quality of life.