食管空肠双吻合在腹腔镜下全胃切除术中的应用

Application of esophago-jejunal double stapling anastomosis in laparoscopy-assisted total gastrectomy

目的探讨食管空肠双吻合技术在腹腔镜下全胃切除手术中应用的可行性和效果。方法回顾性分析2012年4月至2014年10月同济大学附属第十人民医院胃肠外科15例行腹腔镜下全胃切除术患者手术时间、术中出血量、术后病理资料、术后肠道功能恢复时间等资料。结果 15例患者均成功完成腹腔镜下全胃切除手术。手术时间为(223.2±21.67)min,术中出血量为(105.9±19.88)ml,平均清扫淋巴结(25.5±8.3)枚,术后平均排气时间为(2.1±0.98)d,术后下床活动时间为(3.4±1.22)d,平均住院天数为(9.8±2.66)d,2例出现手术相关并发症(肺部感染),其余患者术后恢复良好。结论双吻合技术在腹腔镜全胃切除术中的应用可靠、安全,并可有效避免吻合口狭窄等并发症的发生。

Objective To investigate the feasibility and effectiveness of esophago-jejunal double stapling technique in laparoscopy-assisted total gastrectomy. Methods Clinical data of 15 patients undergoing laparoscopy-assisted total gastrectomy with esophago-jejunal double stapling anastomosis from April 2012 to December 2014 were retrospectively analyzed. The operation time,intraoperative blood loss, histopathological results, time of intestinal function recovery were documented.Results Laparoscopic total gastrectomy with esophago-jejunal double stapling anastomosis was successfully completed in 15 patients. The operative time was（ 223. 2 ± 21. 67） min,blood loss was（ 105. 9 ± 19. 88） ml,average dissected lymph nodes were（ 25. 5 ± 8. 3）,exhaust time was（ 2. 1 ±0. 98） d,postoperative ambulation time was（ 3. 4 ± 1. 22） d,average length of hospital stay was（ 9. 8 ± 2. 66） d. No other surgery-related complications were observed,except 2 cases of pulmonary infection. Conclusion Double stapling technique in laparoscopy-assisted total gastrectomy is reliable,safe and minimally invasive,which can effectively prevent the occurrence of anastomotic stricture and promote fast postoperative recovery.