腹腔镜十二指肠空肠吻合术治疗肠系膜上动脉压迫综合征  

Laparoscopic duodenojejunostomy for the treatment of superior mesenteric artery compressing syndrome

作　　者：王钊[1] 王群[1] 王佳辰[1] 袁甲翔[1] 刘阳[1] 陈洋[1] 司亚蜩 王家祥[1] 洪德飞[2] 

机构地区：[1]郑州大学第一附属医院腹腔镜外科,450052 [2]浙江省人民医院肝胆外科

出　　处：《中华普通外科杂志》2016年第6期468-471,共4页Chinese Journal of General Surgery

摘　　要：目的比较十二指肠“C”形环内侧与外侧两种十二指肠空肠侧侧吻合方式在腹腔镜肠系膜上动脉压迫综合征治疗中的疗效。方法回顾性分析21例腹腔镜下肠系膜上动脉压迫综合征手术，其中8例空肠在十二指肠“C”形环内侧行十二指肠空肠侧侧吻合，13例空肠在十二指肠“c”形环外侧行十二指肠空肠侧侧吻合。结果本组21例患者均顺利完成手术，无中转开腹手术。内侧吻合组和外侧吻合组平均手术时间分别为（123±42）min和（176±43）min，两组相比差异有统计学意义，t=2．780，P〈0．05；术中平均出血量分别为（30±11）ml和（51±25）ml，两组相比差异有统计学意义，t=2．186，P〈0．05；术后肛门排气时间分别为（2．8±0．7）d和（3．6±1．0）d，两组相比差异有统计学意义，t=2．199，P〈0．05；术后平均住院时间分别为（11±6）d和（25±27）d，两组相比差异无统计学意义，t=1．740，P=0．104；术后近期并发症发生率分别为13％和23％，两组相比差异无统计学意义，X^2=0．359，P=0．549。结论腹腔镜下经十二指肠内侧与空肠侧侧吻合治疗肠系膜上动脉压迫综合征比经十二指肠外侧吻合手术时间短、术中出血量少、术后恢复快。Objective To compare therapeutic effects of two types of side to side duodenojejunostomy that the anastomosis was made inside the C-loop of duodenum （the medial group） and that outside the C loop （lateral group） in laparoscopic treatment for superior mesenteric artery compressing syndrome （SMACS）. Methods In this study, single surgeon group performed surgery on 8 medial cases and 13 lateral cases. Clinical data including operative time, intra-operative blood loss, post-operative complications and hospital stay were compared between the two groups. Results All patients underwent laparoscopic duodenojejunostomy successfully. The average operative time of the medial and lateral anastomosis group was （123 ±42） min and （176±43） rain （t =2.780, P 〈0.05）. The mean intro- operative blood loss was （30 ± 11 ） ml and （51 ± 25 ） ml （ t = 2. 186, P 〈 0. 05 ）. The post-operative anal exhaust time was （2.8±0.7）d and （3.6 ± 1.0）d （t =2.199, P 〈0.05）. There was no significant differences of the post-operative complications between the two groups （ 13% vs. 23% , X^2= = 0. 359, P = 0. 549）. Conclusions For SMACS patients undergoing side-to-side laparoscopic duodeuojejunostomy, those with medial anastomosis comparing to lateral anastomosis have the advantage of shorter operative time, less intra-operative blood loss, faster recovery of gastrointestinal function and better short term effect.

关 键 词：上肠系膜动脉综合征 吻合术 外科 腹腔镜 

分 类 号：R657.2[医药卫生—外科学]