改良三角吻合应用于腹腔镜远端胃癌根治术54例临床报告  

Modified delta-shaped gastroduodenostomy in laparoscopic distal gastrectomy for gastric cancer:a clinical report of 54 cases

作　　者：王再兴[1] 蔡逊[1] 马丹丹 金炜东 张建新[1] 

机构地区：[1]中国人民解放军武汉总医院普通外科,武汉430070

出　　处：《腹部外科》2017年第4期288-290,294,共4页Journal of Abdominal Surgery

摘　　要：目的探讨腹腔镜远端胃癌D2根治术采用改良三角吻合技术施行消化道重建的可行性、安全性及临床疗效。方法收集自2014年1月至2016年1月间54例病例资料,均施行腹腔镜远端胃癌D2根治术并采用改良三角吻合技术施行消化道重建。结果 54例成功施行手术。吻合时间为(26.0±4.5)min,术中出血量中位数106 ml(75~158 ml),切口长度为(2.0±1.5)cm。术后第1天C反应蛋白为(19.0±6.4)mg/L,疼痛评分(VAS评分)第1天为(4.1±0.9)分、第2天为(1.7±0.7)分,肛门排气时间为(2.3±1.7)d,拆线时间为(6.4±1.5)d,术后住院时间为(8.5±1.9)d。术后未发生吻合口相关并发症(吻合口漏、吻合口狭窄、吻合口出血),出现肺部感染1例。结论腹腔镜胃远端癌D2根治术中采用改良三角吻合技术施行消化道重建安全可行,临床效果满意。是远端胃癌可考虑采取的消化道重建方式。Objective To investigate the feasibility,safety and clinical efficacy of modified delta-shaped gastroduodenostomy in laparoscopic distal gastrectomy for gastric cancer.Methods A retrospective study was performed from January2014 to January2016 on54 cases of gastric cancer successfully undergoing laparoscopic distal gastrectomy with modified delta-shaped anastomosis.Results 54 cases were operated successfully.The mean anastomosis time was（26.0±4.5）min,the median blood loss was 106（75-158）mL,and the mean length of incision was（2.0±1.5）cm,C reactive protein was（19.0±6.4）mg/L at the first day after the operation,the mean pain score（VAS score）at the first and second day was（4.1±0.9）and（1.7±0.7）respectively.The mean flatus time was（2.3±1.7）days,the removal time of stitches was（6.4±1.5）days,and the mean postoperative hospital was（8.5±1.9）days.There were no anastomotic complications（anastomotic leakage,anastomotic stenosis,anastomotic bleeding）,and pulmonary infection occurred in one case.Conclusions The modified delta-shaped anastomosis is feasible and safe in laparoscopic distal gastrectomy for gastric cancer.

关 键 词：腹腔镜 远端胃癌 

分 类 号：R735.2[医药卫生—肿瘤]