中国实用外科杂志

中国实用外科杂志

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腹腔镜残胃癌根治术中应用三角吻合技术研究（附8例报告）

刘宏斌，许    威，于建平，韩晓鹏，李洪涛，苏    琳   

  1. 兰州军区兰州总医院普通外科，甘肃兰州 730050
  • 出版日期:2015-02-01 发布日期:2015-01-23

  • Online:2015-02-01 Published:2015-01-23

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摘要：

目的    探讨腹腔镜残胃癌根治术运用食管空肠三角吻合的安全性及近期疗效。方法    回顾性分析2013年6月至2014年4月兰州军区兰州总医院收治的8例残胃癌病人的临床资料，均行腹腔镜残胃癌根治术，消化道重建采用食管空肠三角吻合，分析病人术中术后情况、淋巴结清扫、并发症等并随访观察。结果    8例病人均成功施行腹腔镜残胃癌根治术，平均手术时间（213.8±21.7）min，其中食管空肠三角吻合时间（29.3±4.8）min，术中出血量（105.6±23.4）mL，清扫淋巴结（29.8±4.1）枚。所有病人均于术后第1天拔除胃管，术后下床时间（0.8±0.3）d，进食半流质时间（1.8±0.3）d，术后首次通气时间（2.3±0.4）d，术后住院时间（7.3±0.8）d。所有病人术后均未出现吻合口狭窄、梗阻、出血等并发症，无围手术期死亡，均痊愈出院。随访时间为2～12个月，病人一般情况良好，均可正常饮食。结论    腹腔镜残胃癌根治术中采用食管空肠三角吻合技术进行消化道重建安全、可行，近期疗效较好。

关键词: 残胃癌, 腹腔镜, 三角吻合, 胃癌根治术

Abstract:

Application and study of the delta-shaped anastomosis technique in laparoscopic radical resection of gastric stump cancer        LIU Hong-bin，XU Wei，YU Jian-ping，et al. Department of General Surgery, Lanzhou General Hospital of Lanzhou Military Command of PLA，Lanzhou 730050，China
Corresponding author：LIU Hong-bin，E-mail：Liuhongbin999@163.com
Abstract    Objective    To investigate the safety and efficacy of the delta-shaped esophageal and jejunum anastomosis technique in laparoscopic radical resection of gastric stump cancer. Methods    The clinical data of 8 patients with gastric stump cancer admitted between June 2013 and April 2014 in Lanzhou General Hospital of Lanzhou Military Command of PLA were analyzed retrospectively. All the patients were performed laparoscopic radical resection of gastric stump cancer and reconstruction of digestive tract with delta-shaped anastomosis technique. The perioperative status，lymph node dissection and complications were analyzed and followed up. Results    Eight patients were performed laparoscopic radical resection of gastric stump cancer successfully. The average operation time was (213.8±21.7) min，including the delta-shaped esophageal and jejunum anastomosis time (29.3±4.8) min. The average amount of bleeding was (105.6±23.4) mL and the average number of lymph node was 29.8±4.1. All the patients were extubated on the first days after operation with the average bed time after operation (0.8±0.3) d，semi liquid food time (1.8±0.3) d，the first ventilation time after operation (2.3±0.4) d，the average hospital stay time after operation (7.3±0.8) d. There was no case of postoperative anastomotic stricture，obstruction，hemorrhage and other complications related to operation，and no death during perioperative period. All the patients recovered and were discharged. The follow-up time was (2-12) months. All the patients were in good condition，can be fed normal diet. Conclusion    The delta-shaped anastomosis technique in reconstruction of digestive tract is safe，feasible in laparoscopic radical resection of gastric stump cancer. It can obtain satisfactory short-term effect.

Key words: gastric stump cancer, laparoscopy, the delta-shaped anastomosis, radical resection of gastric cancer