中国实用外科杂志

中国实用外科杂志 ›› 2021, Vol. 41 ›› Issue (10): 1173-1175.DOI: 10.19538/j.cjps.issn1005-2208.2021.10.14

• 临床新技术 • 上一篇    下一篇

右开襟单肌瓣成形术用于腹腔镜近端胃切除术消化道重建1例报告及可行性分析

彭    巍，黄懿恺，程    明，张静宇，刘天华，陈    强，陈正荣，龚    巍，邢春根，吴永友   

  1. 苏州大学附属第二医院胃肠外科 ，江苏苏州215004
  • 出版日期:2021-10-01 发布日期:2021-10-19

  • Online:2021-10-01 Published:2021-10-19

摘要： 目的    分析右开襟单肌瓣成形术用于腹腔镜近端胃切除术消化道重建的可行性。方法    2021年3月苏州大学附属第二医院胃肠外科收治1例Siewert Ⅱ型食管胃结合部腺癌病人，行腹腔镜近端胃切除术，采用器械吻合+手工缝合，行食管-残胃吻合、右开襟单肌瓣成形术，术后随访观察并发症发生情况及病人生活质量。结果    手术顺利完成，手术时间262 min，吻合时间119 min。术后随访6个月，未发生吻合口漏、出血、吻合口狭窄、反流性食管炎等并发症，吻合口造影通畅，体重恢复至术前水平，无肿瘤复发。结论    右开襟单肌瓣成形术在保证浆肌瓣血供、简化手术操作方面可能具有一定优势，值得进一步临床验证。

关键词: 右开襟单肌瓣成形术, 腹腔镜近端胃切除术, 反流性食管炎, 吻合口并发症

Abstract: Initial exploration of right-opened single flap plasty in the reconstruction following laparoscopic proximal gastrectomy        PENG Wei，HUANG Yi-kai，CHENG Ming，et al. Department of Gastrointestinal Surgery, the Second Affiliated Hospital of Soochow University，Suzhou 215004，China 
Corresponding author: WU Yong-you，E-mail: woyoyo@aliyun.com
Abstract    Objective   To introduce a modified procedure for reconstruction following laparoscopic proximal gastrectomy. Methods    In March, 2021, a male patient diagnosed with Siewert Type II esophagogastric junction adenocarcinoma in the Second Affiliated Hospital of Soochow University accepted laparoscopic proximal gastrectomy and esophagogastrostomy using right-opened single flap plasty technique. Postoperative complications and patient quality of life（QOL） were noted. Results    The operation was successful. The overall operation time was 262 min and the time for anastomosis was 119 min. During 6 months follow-up, there were no complications such as anastomotic fistula, postoperative bleeding, anastomotic stenosis or reflux esophagitis. The anastomosis was unobstructed, weight returned to preoperative level, without tumor recurrence. Conclusion    Right-opened single flap plasty may have potential benefit in maintaining the blood supply of the flap and simplifying the frustrating hand-sewn double flap technique in the reconstruction of esophagogastric reconstruction. 

Key words: right-opened single flap plasty, laparoscopic proximal gastrectomy, reflux esophagitis, anastomotic complications