残胃近端空肠反转Roux-en-Y吻合在全腹腔镜远端胃癌根治术中的应用  

Application of stomach reversal jejunum Roux-en-Y anastomosis in totally laparoscopic distal gastrectomy

作　　者：李栋梁 罗建飞[2] 闫瑞承[2] 赫杰[2] LI Dongliang;LUO Jianfei;YAN Ruicheng;HE Jie(Dept. of Gastrointestinal Surgery,Xishui People's Hospital,Xishui 438200,Hubei,China;Dept. of Gastrointestinal Surgery,Renmin Hospital of Wuhan University,Wuhan 430060,Hubei,China)

机构地区：[1]湖北省浠水县人民医院胃肠外科,湖北浠水438200 [2]武汉大学人民医院胃肠外一科,湖北武汉430060

出　　处：《武汉大学学报（医学版）》2019年第1期69-72,共4页Medical Journal of Wuhan University

摘　　要：目的:探讨全腹腔镜远端胃癌根治术后采用残胃近端空肠反转Roux-en-Y吻合进行消化道重建的手术方式的临床应用。方法:回顾性总结12例远端胃癌患者行全腹腔镜下远端胃癌根治术后采用残胃近端空肠反转Roux-en-Y吻合的消化道重建方式的手术方法和手术后情况。结果:12例患者均完成全腹腔镜下残胃近端空肠反转Roux-en-Y吻合,手术时间(265.0±23.6)min,消化道重建时间(46.0±13.2)min,出血量为(57.0±19.5)mL。术后患者排气时间为(2.7±0.5)d,术后住院时间为(8.2±1.4)d,淋巴结清扫数目(29.4±5.6)枚,没有发生手术相关早期并发症。结论:全腹腔镜下采用残胃近端空肠反转Roux-en-Y吻合的消化道重建的方式安全,操作简便,术后恢复快,更符合肿瘤手术无瘤原则,是一种理想的全腹腔镜胃癌根治术后消化道重建方式。Objective: To study the surgical method of stomach reversal jejunum Roux-en-Y anastomosis in totally laparoscopic distal gastrectomy(TLDG). Methods: We retrospectively analyzed the surgical technique and postoperative recovery of 12 distal gastric cancer patients who received stomach reversal jejunum Roux-en-Y anastomosis in TLDG. Result: Stomach reversal jejunum Roux-en-Y anastomosis in TLDG were completed successfully in all 12 patients. The operation time was(265.0 ± 23.6)min, the anastomosis time was(46.0± 13.2) min, the volume of bleeding was(57.0± 19.5) mL, the postoperative exhausting time was(2.7 ± 0.5) d, and hospital stay after operation was(8.2 ± 1.4) d.The average number of dissected lymph nodes was 29.4± 5.6. No surgery related complications happened.Conclusion: Stomach reversal jejunum Roux-en-Y anastomosis in TLDG was safe and feasible,resume fast after the operation, conforming to principle of tumor-free technique, and was an ideal anastomosis method for TLDG.

关 键 词：胃癌 全腹腔镜远端胃切除 胃空肠Roux-en-Y吻合 

分 类 号：R656.6[医药卫生—外科学]