经鼻空肠营养管置入技术在全达芬奇机器人胃癌根治术中的应用:附视频  

Application of transnasal jejunal nutrition tube placement in total da Vinci robotic radical gastrectomy for gastric cancer:video attached

作　　者：郭洪海[1] 胡奕炀 田园[1] 庞悦 杨家轩 杨沛刚[1] 丁平安 赵群[1] Guo Honghai;Hu Yiyang;Tian Yuan;Pang Yue;Yang Jiaxuan;Yang Peigang;Ding Ping’an;Zhao Qun(The Third Department of Surgery,the Fourth Hospital of Hebei Medical University,Hebei Key Laboratory of Precision Diagnosis and Comprehensive Treatment of Gastric Cancer,Shijiazhuang 050011,China)

机构地区：[1]河北医科大学第四医院外三科,河北省胃癌精准诊断与综合治疗重点实验室,石家庄050011

出　　处：《中华普通外科学文献（电子版）》2023年第3期193-196,共4页Chinese Archives of General Surgery(Electronic Edition)

基　　金：政府资助临床医学优秀人才培养项目(2019012);河北省高等学校科学技术研究项目(ZD2019139);河北适宜卫生技术库入库项目(2019024)。

摘　　要：目的探讨并总结经鼻空肠营养管置入技术在全达芬奇机器人胃癌根治术中的应用技巧及体会,以及置管过程中常见问题及解决方法。方法收集2019年12月至2021年9月河北医科大学第四医院行全达芬奇机器人胃癌根治术中置入经鼻空肠营养管的192例患者资料,总结操作步骤,记录术中营养管置入时间、术后经管行肠内营养开始时间、首次排气时间、肠内营养并发症等情况。结果192例患者中远端胃切除129例(均为毕Ⅱ式+Braun’s吻合),全胃切除39例(均为食管-空肠π式吻合),近端胃切除24例(均为空肠间置吻合),置管满意183例(95.31%),置管耗时(3.65±2.15)min,术后肠内营养开始时间为(16.59±2.43)h,首次排气时间为(3.26±1.52)d;除11例(5.73%)出现喂养不耐受外,181例(94.27%)耐受良好。结论全达芬奇机器人下胃癌根治术中经鼻置入空肠营养管安全有效,整体上不影响手术时长,是早期开展肠内营养治疗的基础。Objective To summarize the application skills,experience,common problems and solutions in the process of naso-jejunal feeding tube placement in total da Vinci robotic radical gastrectomy.Methods 192 cases with gastric cancer undergoing naso-jejunal feeding tube placement during total da Vinci robotic D2 radical gastrectomy in the Fourth Hospital of Hebei Medical University between December 2019 and September 2021 were reviewed.The time of naso-jejunal tube insertion,enteral nutrition through tube after operation,first exhaust,and the enteral nutrition-related complications were recorded.Results 129 cases underwent distal gastrectomy(Billroth’sⅡ+Braun’s anastomosis),39 cases underwent total gastrectomy(esophageal jejunalπanastomosis),and 24 cases underwent proximal gastrectomy(jejunal interposition anastomosis).183 cases were satisfied with catheterization,the average time of tube placement was(3.65±2.15)min,the time of enteral nutrition after operation was(16.59±2.43)h,and the time of first exhaust was(3.26±1.52)d.Except for 11 cases with feeding intolerance,the rest of the patients had good tolerance.Conclusions The placement of transnasal jejunal nutrition tube in total da Vinci robotic radical gastrectomy is safe and effective,which does not affect the length of operation as a whole,and is the basis for early enteral nutrition therapy.

关 键 词：空肠营养管 达芬奇机器人 胃肿瘤 手术 

分 类 号：R735.2[医药卫生—肿瘤]