专题研究(Monographic Study)

食管悬吊法食管空肠吻合在完全腹腔镜全胃切除术中的应用

Published at: 2017年第26卷第4期

潘华 1 , 黄俊 1 , 罗洪亮 1 , 朱正明 1
1 南昌大学第二附属医院 胃肠外科,江西 南昌 330006
通讯作者 正明 朱 Email: zzm8654@163.com
DOI: 10.3978/j.issn.1005-6947.10.3978/j.issn.1005-6947.2017.04.009
基金:

摘要

目的:探讨完全腹腔镜全胃切除术(TLTG)中采用食管悬吊法行食管空肠手工缝合的安全性及有效性。方法:回顾性分析2016年1月—2017年1月17例行TLTG食管悬吊法食管空肠手工缝合患者资料(悬吊组),并与同期17例行TLTG传统手工缝合的患者临床资料(传统组)比较。结果:两组患者术前资料具有可比性,34例手术均成功完成,无中转开腹。与传统组比较,悬吊组术中指标除切口长度无统计学差异(3.75 cm vs. 3.79 cm,P=0.142),手术时间(198.35 min vs. 211.65 min)、吻合时间(27.82 min vs. 48.74 min)、出血量(49.68 mL vs. 50.85 mL)均明显降低(均P<0.05);术后指标包括排气时间(2.61 d vs. 2.78 d)、疼痛评分(3.21 vs. 3.89)、住院时间(9.77 d vs. 10.32 d)均明显减少(均P<0.05)。两组患者均未出现术后相关并发症。结论:TLTG中采用食管悬吊法行食管空肠手工缝合安全、有效,且近期效果优于传统手工缝合。


Application of esophageal suspension method for esophagojejunostomy during totally laparoscopy total gastrectomy

Abstract

Objective: To investigate the safety and efficacy of using esophageal suspension method for manual esophagojejunostomy following totally laparoscopic total gastrectomy (TLTG). Methods: The clinical data of 34 patients undergoing TLTG and esophageal suspension manual esophagojejunostomy (suspension group) from January 2016 to January 2017 were retrospectively analyzed, and they were compared with the clinical data of 17 patients undergoing TLTG and traditional manual esophagojejunostomy (traditional group) during the same period. Results: The preoperative data of the two groups were comparable. Operations were successfully completed in all the 34 patients without any open conversion. In suspension group compared with traditional group, except for the length of incision that showed no significant difference (3.75 cm vs. 3.79 cm, P=0.142), the intraoperative variables that included the operative time (198.35 min vs. 211.65 min), anastomosis time (27.82 min vs. 48.74 min) and blood loss (49.68 mL vs. 50.85 mL) were all significantly improved (all P<0.05); the postoperative variables that included the time to gas passage (2.61 d vs. 2.78 d), pain score (3.21 vs. 3.89) and length of hospitalization (9.77 d vs. 10.32 d) were all significantly improved (all P<0.05). No relevant postoperative complications occurred in patients of both groups. Conclusion: Using esophageal suspension method for manual esophagojejunostomy during TLTG is safe and effective, with short-term efficacy superior to that of traditional esophagojejunostomy method.


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引用

引用本文: 华 潘, 俊 黄, 洪亮 罗, 正明 朱. 食管悬吊法食管空肠吻合在完全腹腔镜全胃切除术中的应用[J]. 中国普通外科杂志, 2017, 26(4): 457-462.
Cite this article as: PAN Hua, HUANG Jun, LUO Hongliang, ZHU Zhengming . Application of esophageal suspension method for esophagojejunostomy during totally laparoscopy total gastrectomy [J]. Chin J Gen Surg, 2017, 26(4): 457-462.