完全腹腔镜远端胃癌D_2根治术毕Ⅰ式吻合(德尔塔吻合)(附23例报告)  

Totally laparoscopic D_2 radical operation Billroth Ⅰ anastomosis (Delta-shaped anastomosis) for distal gastric cancer:with a report of 23 cases

作　　者：李刚[1] 宫向前[1] 张华平[1] 杨俊奇 刘帅[1] 冯立民[1] 张华杰[1] 

机构地区：[1]青岛大学医学院附属烟台毓璜顶医院,山东烟台264000

出　　处：《腹腔镜外科杂志》2014年第5期367-369,共3页Journal of Laparoscopic Surgery

摘　　要：目的：探讨完全腹腔镜远端胃癌D：根治术毕Ⅰ式吻合技术的可行性与安全性。方法：回顾总结2012年4月至2013年7月为23例远端胃癌患者行完全腹腔镜下胃癌D，根治术毕Ⅰ式吻合的临床资料。结果：23例均顺利完成远端胃大部切除胃十二指肠毕Ⅰ吻合术，无一例中转开腹。手术时间170—280min，平均（228±46）min；术中出血量30—170ml，平均（60±23）ml；术中行德尔塔吻合的时间为23～45min，平均（31±21）min；清扫淋巴结17～29枚，平均（25±9）枚。术后病理分期I。期9例、Ⅱ期14例。结论：胃十二指肠毕Ⅰ吻合术操作简单、可行，手术更加安全、便捷，尤其对于进展期胃癌的治疗更加符合消化道的生理解剖，利于胃肠功能的恢复，是安全、有效的完全腹腔镜下胃大部切除术后的重建方式。Objective：To evaluate the safety and feasibility of totally laparoscopic D2 radical operation Billroth I anastomosis for distal gastric cancer. Methods： Clinical data of 23 patients who suffered from distal gastric cancer and underwent laparoscopic D2 radical resection Billroth I anastomosis from Apr. 2012 to Jul. 2013 were retrospectively analyzed. Results：All the laparoscopic D2 radical operations for gastric cancer were successful, without conversion to laparotomy. The operative time was 170-280 min[ average （228± 46） min ], blood loss was 30-170 ml [ average （60 ± 23 ） ml ], operative time for Delta-shaped anastomosis was 23-45 rain [ average （31 ± 21 ） min ], number of dissected lymph nodes was 17-29 [ average （25 _＋ 9） ]. The TNM classification of the tumor were 9 cases of stage I s, 14 cases stage I1. Conclusions： Gastroduodenal Billroth I anastomosis is easy, safe and feasible especially for advanced gastric cancer, more suitable for psysiological anatomy of digestive tract, propitious to recovery of gastrointestinal function. This is a safe and effective reconstruction procedure for totally laparoscopic subtotal gastrectomy.

关 键 词：胃肿瘤 腹腔镜检查 消化道重建 德尔塔吻合 

分 类 号：R735.2[医药卫生—肿瘤]