中国实用外科杂志

中国实用外科杂志

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腹腔镜下改良Overlap法食管空肠吻合11例临床分析

郑佳彬，吴德庆，王俊江，胡伟贤，冯兴宇，杨梓锋，李    勇   

  1. 广东省医学科学院 广东省人民医院普通外科，广东广州 510080
  • 出版日期:2018-01-01 发布日期:2018-01-17

  • Online:2018-01-01 Published:2018-01-17

摘要：

目的    探讨全腹腔镜下改良Overlap法食管空肠吻合的安全性及有效性。方法    回顾性分析2015年2—12月广东省人民医院普通外科收治的行腹腔镜胃癌根治术的11例胃上部癌病人的临床资料，术中均行改良Overlap法食管空肠吻合，即将线性吻合变为三角吻合，并使用器械吻合关闭共同开口。观察术中及术后情况。结果    所有病人均顺利完成手术，无中转开腹。食管空肠吻合时间为36（22~65）min；手术切口长度为5.5（5.0～7.0）cm；术后恢复进食全流质时间为4（3~5）d；术后住院时间为8（6~11）d。1例病人术后第2天出现吻合口出血，予胃镜下止血，其余病人均未出现并发症。术后5 d均行上消化道造影检查，未发现吻合口漏和吻合口狭窄。术后3个月复查消化道造影未见吻合口狭窄。结论    全腹腔镜下改良Overlap法食管空肠吻合操作简便，是一种安全可行的吻合方式。

关键词: 改良Overlap, 全腹腔镜, 食管空肠吻合, 胃癌

Abstract:

Modified totally laparoscopic Overlap esophagojejunal anastomosis: A safe and feasible technique        ZHENG Jia-bin，WU De-qing，WANG Jun-jiang，et al. Department of General Surgery，Guangdong General Hospital & Guangdong Academy of Medical Sciences，Guangzhou 510080，China
Corresponding author：LI Yong，E-mail：yuan821007@126.com
ZHENG Jia-bin and WU De-qing contributed equally to the study
Abstract    Objective    To modify the totally laparoscopic overlap esophagojejunal anastomosis, and evaluate the efficiency and safety of this modified overlap anastomosis. Methods    Clinical data of 11 patients with upper gastric cancer performed totally laparoscopic radical gastrectomy between February and December 2015 in Department of General Surgery, Guangdong General Hospital were analyzed retrospectively. All patients underwent modified Overlap esophageal-jejunum anastomosis, which made the linear anastomosis into a triangular anastomosis, and used the device to close the common anastomosis. Intraoperative and postoperative conditions were observed. Results    The modified overlap anastomosis was successfully applied to 11 patients. The mean esophagojejunal anastomosis times were from 22 to 65min (median time 36min). The lengths of incision were from 5.0 to 7.0 cm (median length 5.5cm). The times of return to liquid diet after surgery were from 3 to 5days (median time 4 days), while postoperative hospital stay was from 6 to 11days (median time 8days). No anastomotic leakage and anastomotic stenosis was found before discharge. No patients had anastomotic stenosis after three months of follow-up angiography again. Conclusion    Modified overlap laparoscopic esophagojejunal anastomosis is a  portable and feasible technique for anastomosis.

Key words: modified Overlap, totally laparoscopy, esophagojejunal anastomosis, gastric cancer