中国实用外科杂志

• 医学研究生园地 • 上一篇    下一篇

腹腔镜胃底折叠抗反流术联合胃袖状切除术动物实验研究

艾克拜尔·艾力,克力木·阿不都热依木,张    成,皮尔地瓦斯,阿力木江·麦斯依提,赛甫丁,王    志   

  1. 新疆维吾尔自治区人民医院微创外科、疝及腹壁外科,新疆乌鲁木齐 830001
  • 出版日期:2015-02-01 发布日期:2015-01-23

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

摘要:

目的    观察腹腔镜胃底折叠抗反流手术联合胃袖状切除术对动物模型的可行性和安全性。方法    2013年12月至2014年5月在柯惠上海临床培训中心及奥林巴斯上海实验室对8只小猪行腹腔镜下保留部分胃底的胃袖状切除术联合食管裂孔疝修补术及不同类型胃底折叠术(包括Nissen、Toupet、Dor胃底折叠术)。记录术中情况、手术步骤、技术难点及注意事项等。结果    成功完成小猪腹腔镜胃袖状切除术和食管裂孔疝缝合修补术8次,不同类型胃底折叠术24次,即Nissen胃底折叠术、Toupet胃底折叠及Dor胃底前折叠术各8次。无一例中转开腹,所有实验动物均在手术中生命体征保持平稳,平均手术时间为(120.2±13.7)min,出血量为5~80(35.8±11.1)mL。术中1只发生肝损伤出血,其余均未发生脏器损伤及吻合口漏。手术时间随着训练次数明显缩短。
结论    腹腔镜胃底折叠抗反流手术联合胃袖状切除术对小猪动物模型安全可行,可为临床医师提供极佳训练机会,有助于缩短学习曲线,可能成为治疗肥胖合并胃食管反流病或食管裂孔疝的新型抗反流手术方法。

关键词: 腹腔镜, 抗反流手术, 胃袖状切除术, 动物模型

Abstract:

Establishment of laparoscopic fundoplication with sleeve gastrectomy in a porcine model        Aikebaier Aili,Kelimu Abudureyimu,ZHANG Cheng,et al. Department of Laparoscopic Surgery,the People’s Hospital of Xinjiang Uyghur Autonomous Region,Urumqi 830001,China
Corresponding author: Kelimu Abudureyimu,E-mail: klm6075@163.com
Abstract    Objective    To study the feasibility and safety of laparoscopic fundoplication with sleeve gastrectomy in the porcine model. Methods    A total of eight minipigs underwent revised sleeve gastrectomy which reserved a small part of fundus,then underwent esophageal hiatal hernia repair and fundoplications including Nissen fundoplication,Toupet fundoplication,Dor fundoplication between December 2013 and May 2014 in Covidien (Shanghai)Clinical Training Center and Olympus  (Shanghai)Laboratory.  Intraoperative complications,main operative procedure,technical difficulties and cautions were recorded. Results    Eight cases of sleeve gastrectomy with small part of reserved fundus and esophageal hiatal hernia repair and 24 cases of fundoplications were performed laparoscopically on eight minipigs. Three types of fundoplications as Nissen,Toupet and Dor fundoplication were performed orderly on each minipig. Vital signs of all animals were stable during the procedure. The mean operation time was (120.2±13.7)min,and the mean blood loss was (35.8±11.1)mL. There was no complication except one liver damage. Operation time shorten significantly after practicing. Conclusion    Establishment of laparoscopic fundoplication with sleeve gastrectomy in minipig can be feasible and safe,and it  can provide very helpful training opportunities for surgeons. The new surgical procedure would be an acceptable option for treating gastroesophageal reflux disease or hiatal hernia in morbidly obese patients.

Key words: laparoscope, anti-reflux surgery, sleeve gastrectomy, animal model