β形Roux—en—Y吻合在全腹腔镜远端胃癌根治术中的应用  

Application of β-shaped intracorporeal Roux-en-y reconstruction in totally laparoscopic distal gastrectomy

作　　者：王楠[1] 乔庆[1] 吴涛[1] 郑波波[1] 谢爽[1] 王珂[1] 张波[1] 杨莹[1] 周帅[1] 何显力[1] 

机构地区：[1]第四军医大学附属唐都医院普通外科,西安710038

出　　处：《中华胃肠外科杂志》2015年第11期1102-1105,共4页Chinese Journal of Gastrointestinal Surgery

基　　金：国家自然科学基金（81200330）

摘　　要：目的探讨β形Roux-en—Y吻合（β吻合）在全腹腔镜下远端胃癌根治术中的可行性和安全性．方法回顾性分析2014年1—5月间第四军医大学唐都医院开展的21例完全腹腔镜下远端胃癌根治术并8吻合患者的临床资料。结果21例患者均成功实施完全腹腔镜下的远端胃癌D2根治术并β吻合。手术时间（229．0±18．7）min，β吻合时间（27．5±4．2）min，术中出血量（91．0±38．3）ml。淋巴结清扫数（33．2±4．6）枚，上、下切缘距离分别为（5．9±0．4）cm和（3．2±0．8）cm，切缘均未见癌细胞残留。术后进流食时间（2．1±0．8）d，肛门排气时间（3．1±0．9）d，术后住院时间（5．9±2．4）d。术后卅现肺部感染1例，腹腔感染1例，无吻合口相关并发症发生。结论β吻合技术应用于全腹腔镜下远端胃癌根治术安全可行，近期疗效满意。Objective To explore the technical feasibility, safety, and clinical efficacy of β-shaped Roux-en-Y reconstruction （β reconstruction） in totally laparoscopic distal gastrectomy （TLDG）. Methods Clinical data of 21 patients with gastric cancer undergoing TLDG with β reconstruction from January 2014 to May 2014 were retrospectively analyzed. Results TLDG with β reconstruction was successfully performed in all the patients. The mean time of operation and β reconstruction was （229.0±18.7） rain and （27.5±4.2） min. The blood loss was （91.0±38.3） ml and number of dissected lymph node was 33.2±4.6 per patient. The length of upper and lower segment of resection from lesion was （5.9±0.4） cm and （3.2±0.8） era. The average time to resume fluid diet, time to restore flatus and hospital stay were （2.1±0.8） d, （3.1±0.9） d and （5.9±2.4） d, respectively. Conclusion The β reconstruction is a safe and feasible procedure for TLDG and provides satisfactory short-term efficacy.

关 键 词：胃肿瘤 远端胃切除术 腹腔镜 Roux—en—Y吻合 

分 类 号：R735.2[医药卫生—肿瘤]