手工吻合空肠间置术联合完全腹腔镜下远端胃切除术18例分析  

Analysis of hand-sewn jejunum interposition and anastomosis combined with totally laparoscopic distal gastrectomy:a report of 18 cases

作　　者：邓龙廉 恩日乐图 张豆豆 王腾祺[2] DENG Longlian;Enri-Letu;ZHANG Doudou;WANG Tengqi(Inner Mongolia Medical University,Hohhot,Inner Mongolia,010110;Department of Gastrointestinal Surgery,Bayannur Hospital of Inner Mongolia Autonomous Region,Bayannur,Inner Mongolia,015000)

机构地区：[1]内蒙古医科大学,内蒙古呼和浩特010110 [2]内蒙古自治区巴彦淖尔市医院胃肠外科,内蒙古巴彦淖尔015000

出　　处：《实用临床医药杂志》2021年第17期119-123,共5页Journal of Clinical Medicine in Practice

基　　金：内蒙古自治区应用技术研究与开发项目(201802138);内蒙古医科大学“科技百万工程”联合项目[YKD2020KJBW(LH)059]。

摘　　要：目的观察手工吻合空肠间置术(HJIA)在远端胃癌患者完全腹腔镜下远端胃切除术(TLDG)中的应用效果。方法回顾性收集接受TLDG联合HJIA治疗的18例远端胃癌患者的临床资料,采用描述性研究方法分析患者资料,并采用SPSS软件分析相关数据。结果18例患者平均手术时间为(324.33±57.94)min,术中失血量为20.00(20.00,100.00)mL,术中手工吻合所需耗材费用为(2875.40±531.43)元人民币,首次术后排气时间为2.50(2.00,3.00)d,首次术后进流食时间为5.00(2.00,6.00)d,术后住院时间为12.00(10.00,16.25)d。18例患者中,发生十二指肠吻合口瘘1例(经保守治疗和手术治疗后出院)、术后胃瘫1例(经保守治疗后出院)和肺部感染合并乳糜漏1例(经保守治疗后出院)。18例患者均完成随访,随访时间1~12个月,随访期内所有患者无胃癌复发及转移情况。4例患者随访时无临床症状,但胃镜检查发现有胃潴留。结论对于远端胃癌患者而言,由腹腔镜操作技术娴熟的医生实施TLDG联合HJIA治疗是可行的。Objective To observe the effect of hand-sewn jejunal interposition anastomosis(HJIA)in totally laparoscopic distal gastrectomy(TLDG)in patients with distal gastric cancer.Methods The clinical data of 18 patients with distal gastric cancer who received TLDG combined with HJIA was retrospectively collected.The patients′data was analyzed by descriptive study method,and relevant data was analyzed by SPSS software.Results The average duration of operation,the volume of intraoperative blood loss,cost of consumables used,time to first flatus and time to first postoperative intake of liquid food were(324.33±57.94)min,20.00(20.00,100.00)mL,(2875.40±531.43)Yuan(RMB),2.50(2.00,3.00)d,5.00(2.00,6.00)d,and 12.00(10.00,16.25)d.Of the 18 patients,one patient had a duodenal anastomotic fistula and was discharged after conservative and surgical treatment;one case occurred postoperative gastric paralysis and one case occurred pulmonary infection combined with chyle leakage,both were discharged after conservative treatment.All 18 patients were followed up for 1 month to 12 months.No recurrence or metastasis of gastric cancer occurred in the patients during the follow-up period.Four patients had no clinical symptoms during follow-up,but gastric retention was found by gastroscopy.Conclusion It is feasible for patients with distal gastric cancer to be treated with TLDG combined with HJIA by skilled laparoscopic physicians.

关 键 词：手工吻合 空肠间置术 完全腹腔镜下远端胃切除术 胃癌 

分 类 号：R615[医药卫生—外科学] R735.2[医药卫生—临床医学]