腹腔镜下空肠造瘘在微创食管癌Ivor-Lewis手术中的应用

The application of laparoscopic jejunostomy during complete thoracoscopic and laparoscopic Ivor-Lewis esophagectomy

目的分析腹部不加切口的完全腹腔镜下空肠造瘘术的操作方法,探讨腹腔镜下空肠造瘘在微创食管癌Ivor-Lewis手术中的应用效果。方法回顾性分析行腹部不加切口的完全腹腔镜下空肠造瘘术的279例患者临床资料,观察空肠造瘘术中完成情况、空肠造瘘口渗液、造瘘口局部皮肤感染、管道堵塞、脱落、肠梗阻、二次手术等发生率。结果 279例患者均顺利完成空肠造瘘置管,平均手术时间(16.7±3.2)min,带管时间(30.2±3.6)d,空肠造瘘术后并发症为20.1%,其中造瘘口渗液7例,造瘘管脱落3例,造瘘管堵塞2例,肠梗阻4例,二次手术1例。结论腹部不加切口的完全腹腔镜下空肠造瘘术,是一种可行、较为安全的手术方法,是建立肠内营养途径的有效方法。

Objective To analyze the safety and feasibility of laparoscopic feeding jejunostomy during complete thoracoscopic and laparoscopic Ivor - Lewis Esophagectomy. Methods We retrospectively analyzed 279 patients who received laparoscopic feeding jejunostomy. Complications, including incision exudation and infection, tube blocking and shedding, intestinal obstruction, as well as reoperation were observed. Results All 279 patients were underwent laparo-scopic feeding jejunostomy successfully with （ 16. 7 ± 3. 2 ） min surgical time,mean time with feeding tube was （ 30. 2 土 3.6）d and the rate of complication was 20. 1% including 7 cases with incision exudation,3 cases with tube accident shedding,2 cases with tube blocking,4 cases with intestinal obstruction and lease reoperation. Conclusion Laparo-scopic feeding jejunostomy during complete thoracoscopic and laparoscopic Ivor - Lewis esophagectomy is safe and feasi-ble with a low morbidity and mortality of associated complications.