手工吻合在完全腹腔镜下胃切除空肠间置术中的应用  

Application of Manual Anastomosis in Total Laparoscopic Gastrectomy and Jejunal Interposition

作　　者：张豆豆 孙海滨[2] 王腾祺[2] 恩日乐图 ZHANG Doudou;SUN Haibin;WANG Tengqi;Enriletu(Baotou Medical College of Inner Mongolia University of Science and Technology,Baotou 014060 China;Gastrointestinal Surgery,Bayannaoer City Hospital,Linhe 015000 China)

机构地区：[1]内蒙古科技大学包头医学院,内蒙古包头014060 [2]巴彦淖尔市医院胃肠外科,内蒙古临河015000

出　　处：《内蒙古医学杂志》2022年第8期904-908,F0003,共6页Inner Mongolia Medical Journal

基　　金：内蒙古自治区应用技术研究与开发资金项目“全腹腔镜与腹腔镜辅助下胃切除、空肠间置术术中关键技术的临床研究”(编号:2019GG040);巴彦淖尔市科技创新驱动项目“手工吻合在腹腔镜胃切除空肠间置术中的应用价值”(编号:K202029)。

摘　　要：目的研究手工吻合在完全腹腔镜下胃切除空肠间置术消化道重建方式中的应用效果及安全性。方法收集2017年1月至2021年1月在内蒙古巴彦淖尔市医院胃肠外科行完全腹腔镜下胃切除空肠间置术52例患者的临床资料,根据消化道重建过程中吻合方式的不同分为手工吻合组32例和器械吻合组20例,回顾性对比研究两组围术期相关指标、术后胃肠道功能、术后并发症、术后1~24个月的随访和生存情况。结果完全腹腔镜下胃切除空肠间置术手工吻合与器械吻合在手术时间,术中估计失血量、术后胃肠道功能恢复情况、术后住院时间及术后并发症方面相比均无明显差异(P>0.05)。在术中吻合费用方面,手工吻合组费用明显少于器械吻合组,两组相比有显著差异,差异有统计学意义(P<0.05)。结论手工吻合应用在完全腹腔镜下胃切除空肠间置术后消化道重建中是安全可行的,且经济实用性高,有一定临床推广价值。Objective To study the application effect and safety of manual anastomosis in the reconstruction of digestive tract in total laparoscopic gastrectomy and jejunal interposition.Methods The clinical data of 52 patients who underwent laparoscopic gastrectomy and jejunal interposition in the Department of Gastrointestinal Surgery of Bayannaoer Hospital,Inner Mongolia from January 2017 to January 2021 were collected.The manual anastomosis(32 cases)group and the instrument anastomosis(20 cases)group were compared for perioperative related indicators,postoperative gastrointestinal function,postoperative complications,follow-up and survival from 1 to 24 months after operation.Results There was no significant difference between manual anastomosis and instrument anastomosis in total laparoscopic gastrectomy and jejunal interposition in terms of operation time,estimated intraoperative blood loss,postoperative gastrointestinal function recovery,postoperative hospital stay and postoperative complications.difference(P>0.05).In terms of the cost of intraoperative anastomosis,the cost of manual anastomosis was significantly lower than that of the instrument anastomosis group,and there was a significant difference between the two groups(P<0.05).Conclusion The application of manual anastomosis in the reconstruction of digestive tract after laparoscopic gastrectomy and jejunal interposition is safe and feasible,and has high economical practicability,which has a certain clinical value.

关 键 词：手工吻合 腹腔镜手术 胃癌根治术 空肠间置术 器械吻合 

分 类 号：R656.6[医药卫生—外科学]