机器人下近端胃癌根治术

Robort-assisted proximal gastric cancer surgery

患者为老年男性,68岁,发现贲门巨大肿物,进行新辅助化疗,TC方案,化疗4个周期后,部分缓解后行手术治疗,术后病理诊断为鳞癌,分期yp T2N1M0。主要步骤:离断胃周血管,清扫相应部位淋巴结(D2),离断食管贲门部,经口置入Orvil吻合器,上腹部正中开口,将游离胃体提至腹腔外,距肿瘤远端约5 cm处离断胃体,移除大体标本。纵向切开残胃4 cm,置入胃肠吻合器,与吻合器抵针座衔接,旋紧,激发。置入空肠营养管,检查无出血后,逐层关腹。手术结束。

The patient was a 68-year old men with cardia tumor.The patient was treated by 4 cycles neoadjuvant chemotherapy with partial relief.Postoperative pathological diagnosis was squamous cell carcinoma,staging ypT2N1M0.The main steps were:cutting off gastric perivascular blood vessels,dissection of the corresponding lymph nodes(D2),off the connection of esophageal and cardia.Orvil stapler was inserted via oral.The free gastric body was moved out to through an 8cm abdominal incision.The carcinoma was removed.The gastrointestinal stapler was connected with stapler abutment tightly and stimulating the stapler.Jejunal nutrition tube was installed.Checked abdomen without bleeding and suture the incision layer by layer.