浆肌层缝合法关闭共同开口在腹腔镜远端胃癌根治术中的应用  

Application of seromuscular suture to close the common opening in laparoscopic distal gastrectomy for gastric cancer

作　　者：朱晓峰[1] 鲁振环 张涛[1] ZHU Xiao-feng;LU Zhen-huan;ZHANG Tao(Department of Gastorintestinal Surgery,the Affiliated Yue Bei People's Hospital of Shantou University,Shaoguang 512000,Guangdong,CHINA)

机构地区：[1]汕头大学附属粤北人民医院胃肠外科,广东韶关512000

出　　处：《海南医学》2022年第6期739-742,共4页Hainan Medical Journal

基　　金：广东省韶关市卫生局立项(编号:Y21129)。

摘　　要：目的 评估浆肌层缝合法在关闭胃空肠Overlap吻合的共同开口中的安全性和有效性。方法 选取2018年1月至2019年12月韶关市粤北人民医院收治的需要行腹腔镜远端胃癌根治术的62例患者,按入院顺序均分为浆肌层缝合组(研究组)和器械吻合组(对照组),每组31例。研究组患者采用3-0可吸收线关闭共同开口,对照组采用直线切割闭合器关闭共同开口,比较两组患者术中吻合时出血量、术后吻合口漏发生率、关闭共同开口时间、手术总时长、术后并发症发生率、术后肠道恢复排气时间、排便时间及住院时间等指标。结果 两组患者的术后肛门首次排气时间、术后首次排便时间、术后住院时间比较差异均无统计学意义(P>0.05);研究组患者的关闭共同开口时间为(11.68±0.91) min,明显长于对照组的(6.84±0.79) min,差异有统计学意义(P<0.05),但两组患者吻合时的出血量和整体手术时间比较差异均无统计学意义(P<0.05)。结论 浆肌层缝合法在腹腔镜远端胃癌根治术中关闭胃空肠Overlap吻合的共同开口是安全有效的。Objective To evaluate the safety and efficacy of seromuscular suture to close the common opening of gastrojejunal anastomosis in laparoscopic distal gastrectomy for gastric cancer. Methods Sixty-two patients who were admitted to the Affiliated Yue Bei People’s Hospital of Shantou University from January 2018 to December 2019and were scheduled for laparoscopic distal gastrectomy were selected as the research objects. According to admission order, the patients were divided into the observation group(seromuscular suture group, 31 cases) and the control group(instrument anastomosis group, 31 cases). The patients in the observation group were treated with 3-0 absorbable line to close the common opening, while those in the control group were treated with linear cutting closure device to close the common opening. The blood loss during anastomosis, the incidence of postoperative anastomotic leakage, the time to close the common opening, the duration of operation, the incidence of postoperative complications, the time of postoperative intestinal recovery and exhaust, the time of first defecation after operation, and length of hospital stay were compared between the two groups. Results The time of postoperative intestinal recovery and exhaust, the time of first defecation after operation, and length of hospital stay between the two groups had no significant difference(P>0.05). The time to close the common opening of the observation group was(11.68±0.91) min, which were significantly longer than(6.84±0.79) min of the control group(P<0.05). There was no significant difference in blood loss during anastomosis and the duration of operation between the two groups(P>0.05). Conclusion Seromuscular suture is safe and effective to close the common opening of gastrojejunal anastomosis in laparoscopic distal gastrectomy for gastric cancer.

关 键 词：胃癌 腹腔镜 共同开口 浆肌层缝合 直线切割闭合器 

分 类 号：R735.2[医药卫生—肿瘤]