三角吻合术在全腹腔镜远端胃癌根治消化道重建中的应用  

Clinical application of delta shaped anastomosis in totally laparoscopic distal gastrectomy for digestive tract reconstruction

作　　者：朱志强[1] 姚寒晖[1] 吴杨[1] 邵峰[1] 柏亚平[1] 宁忠良[1] 梁伟[1] 

机构地区：[1]安徽医科大学附属省立医院普通外科,合肥230001

出　　处：《安徽医科大学学报》2013年第11期1410-1412,共3页Acta Universitatis Medicinalis Anhui

摘　　要：回顾性分析10例全腹腔镜远端胃癌根治切除、残胃十二指肠三角吻合病例的临床资料。10例患者均成功实施了全腹腔镜远端胃癌根治切除(D2)、残胃十二指肠三角吻合,手术时间(173±32)min;三角吻合操作时间(25±11)min;术中出血(95±36)ml;淋巴结清扫数目(25±13)枚/例;肿瘤距上切缘(6.5±1.8)cm、距下切缘(4.5±1.6)cm,术后病理结果未见切缘癌残留。首次下床活动时间(1.7±0.6)d,肛门排气时间(3.4±1.6)d,进流质饮食时间(4.0±1.5)d,术后住院时间(7.0±1.0)d。全组未出现呼吸道感染、肠梗阻、吻合口出血、吻合口狭窄、吻合口瘘等并发症。残胃十二指肠三角吻合技术操作安全简便,在全腹腔镜远端胃癌根治术中能提供良好的腹腔内胃十二指肠吻合效果。The clinical data of 10 patients undergoing totally laparoscopic gastrectomy with residual stomach and duodenum delta-shaped anastomosis were retrospectively analyzed. Totally laparoscopic distal gastrectomy with delta- shaped anastomosis was performed successfully in all patients. The operation time was （ 173 ± 32 ） min and the blood loss was （95 ± 36） ml. The time of delta-shaped anastomosis was （25 ± 11 ） rain. The mean number of harvested lymph nodes was （25 ± 13）. The distance from proximal surgical margin to tumor was（6. 5 ±1.8）cm and the distance from distal surgical margin to tumor was （4.5± 1.6） cm, these surgical margins were negative in all samples. The time of gastrointestinal function recovery was （ 3.4 ± 1.6 ） d, out of bed activity time was （ 1.7± 0. 6） d. The hospital stay was （7. 0 ±1.0） d. There was no case of respiratory infections, intestinal obstruction, anastomotic bleeding, anastomotic stricture, anastomotic leakage and other complications. Delta shaped anastomosis is a safe and easy method which can provide a good digestive tract reconstruction in totally laparoscopic distal gastrectomy.

关 键 词：腹腔镜 远端胃切除 三角吻合 胃癌 

分 类 号：R735.2[医药卫生—肿瘤]