直线切割闭合器简化远端胃癌根治消化道重建的临床应用  

Clinical application of linear incision closure in reconstruction of distal gastric cancer

作　　者：何萍[1] 肖金成[1] 徐勇超[1] 任莹坤[1] 唐礼恭[1] 李星[1] 

机构地区：[1]郑州大学附属肿瘤医院河南省肿瘤医院,450008

出　　处：《临床医学》2017年第7期1-3,共3页Clinical Medicine

摘　　要：目的探讨直线切割闭合器在远端胃窦癌根治Billroth Ⅰ式吻合术中的应用技巧及效果。方法选择2012年3月至2013年3月共30例行远端胃切除加Billroth Ⅰ式吻合术的胃窦癌患者,术中采用直线切割闭合器简化手术操作,并和同期采用常规方法治疗的40例患者对照,分析其临床资料及术后近期效果。结果观察组远端切缘长度为(3.8±1.2)cm,对照组为(3.3±1.3)cm,观察组切缘长度大于对照组(P=0.041);观察组吻合时间为(6.5±3.4)min,对照组为(16.0±4.5)min,观察组吻合时间小于对照组(P=0.037)。观察组术后腹腔及切口感染2例,对照组8例,观察组感染率小于对照组(P=0.044)。两组均无吻合口瘘病例。结论使用直线切割闭合器切断十二指肠球部、预置抵钉座在远端胃窦癌根治Billroth Ⅰ式吻合术中的应用能简化手术操作,缩短手术时间。Objective To investigate the technique and effect of linear incision closure in Billroth type I anastomosis of distal gastric cancer. Methods From March 2012 to March 2013, 30 patients with gastric antrum cancer underwent distal gastrectomy with Bitlroth and I anastomosis in our department, the linear cutting closed device was used to simplify the op- eration, and 40 cases in the same period were compared with the routine method. The clinical data and the short - term postoperative effect were analyzed. Results In the observation group, the distal margins length was （3.8 ±1.2） cm, and that of the control group was （3.3 ± 1.3 ） cm, the margin length of observation group was greater than that of the control group （ P = 0.041 ）. In the observation group , the anastomotic time was （6.5 ± 3.4 ） rain, the control group was （ 16.0 ± 4.5 ） min, the anastomotic time of observation group was less than that of the control group（ P = 0.037 ） ; there were 2 ea- ses of abdominal cavity and incision infection in the observation group and 8 cases in the control group, the rate of infection in observation group was lower than that in control group （ P = 0.044）. There was no anastomotic fistula in both groups. Conclusion Use a straight line cutter to break the duodenal bulb, preset tobe nail seat in the distal gastric cancer Billroth I anastomosis can simplify the operation, shorten the operation time.

关 键 词：胃癌 直线切割闭合器 BillrothI式吻合 吻合口瘘 

分 类 号：R735.2[医药卫生—肿瘤]