三角吻合技术在全腹腔镜下远端胃癌根治术中的应用探讨

Application of delta-shaped anastomosis in totally laparoscopic distal gastrectomy

目的探讨三角吻合技术在全腹腔镜下远端胃癌根治胃十二指肠吻合中的可行性及安全性。方法回顾性分析我院肿瘤外科2013年2月—2015年2月完成的60例开腹毕Ⅰ吻合及65例全腹腔镜远端胃癌根治应用三角吻合技术吻合患者的手术相关指标及术后并发症发生率,对比2组患者手术的近期疗效。结果全腹腔镜组手术时间长于开腹组,差异有统计学意义(P<0.05)。全腹腔镜组术中出血、术后首次排气时间、术后住院时间均少于开腹组,差异有统计学意义(P<0.05)。2组淋巴结清扫数目差异无统计学意义(P>0.05)。2组术后均未出现吻合口相关并发症。结论全腹腔镜下远端胃癌根治胃十二指肠三角吻合技术安全可行,具有创伤小、恢复快等优点,易于掌握,近期效果满意。

Objective To investigate the safety and efficacy of delta-shaped anastomosis in totally laparoscopic distal gastrectomy.Methods Between February 2013 and February 2015,60 patients at our department underwent open gastrectomy,and 65 patients underwent laparoscopic gastrectomy（delta-shaped anastomosis）.Clinical features and short-term efficacy of the two groups were analyzed restrospectively.Results The patients in the delta-shaped group were operated on successfully,and no death occurred.Operation time of laparoscopic group was significantly longer than the open group;The two groups had similar mean numbers of dissected lymph nodes;Intraoperative blood loss was significantly less and time to first flatus、postoperative discharge day were significantly shorter with the laparoscopic group.There were no anastomotic leakage in both groups.Conciusion Delta-shaped anastomosis is a safe and feasible surgical procedure for totally laparoscopic distal gastrectomy.