单钳道内镜下经自然腔道胃空肠吻合术在胃出口道梗阻中的初步探索

Preliminary study of single-clamp endoscopic surgery with NOTES gastrojejunostomy in gastric outflow obstruction

目的探讨单钳道内镜下经自然腔道胃空肠吻合术治疗胃出口道良恶性梗阻的效果。方法2018年10月-2019年8月该院消化内镜中心通过20例猪胃及上段空肠建立离体动物模型,选择经自然腔道内镜手术(NOETS),在该模型上采用单钳道内镜下经NOTES胃空肠吻合术,以明确该手术方法治疗胃出口道梗阻的可行性及有效性。结果均成功进行胃空肠吻合,镜身可经吻合口顺利进入空肠上段,手术时间(33.6±6.5)min,金属夹8~10枚,吻合口无渗液。结论该术式成功构建胃空肠吻合,对胃出口道梗阻提供新的手术方式,为临床研究的进一步开展提供理论支持。

Objective To investigate the effect of single-clamp endoscopic surgery for the treatment of benign and malignant obstruction of gastric outflow tract by NOTES gastrojejunostomy.Methods From October 2018 to August 2019,we established an in vitro animal model through 20 cases of porcine stomach and upper jejunum.On this model,single-clamp endoscopic surgery with NOTES gastrojejunostomy was performed.The feasibility and effectiveness of this surgical method in the treatment of gastric outflow obstruction.Results Gastrointestinal anastomosis was successfully performed by this procedure.The lens body can smoothly enter the upper part of the jejunum through the anastomosis.The operation time is(33.6±6.5)min,the number of metal clips is 8~10,and the anastomosis is not exudate.Conclusion This operation successfully constructed gastric jejunal anastomosis,which provided a new surgical method for gastric outflow tract obstruction and theoretical support for further clinical research.