“背驮式”食管空肠Overlap吻合在全腔镜全胃切除术消化道重建中应用研究  

Exploration of"piggyback"esophagojejunal Overlap anastomosis in digestive tract reconstruction after total laparoscopic gastrectomy

作　　者：刘浩 沈振斌[1] LIU Hao;SHEN Zhen-bin(Department of Gastrointestinal Surgery,Zhongshan Hospital,Fudan University,Shanghai 200032,China;Department of General Surgery,Zhongshan Hospital,Fudan University(Xiamen Branch),Xiamen 361015,China)

机构地区：[1]复旦大学附属中山医院胃肠外科,上海200032 [2]复旦大学附属中山医院厦门医院普外科,福建厦门361015

出　　处：《中国实用外科杂志》2024年第3期331-334,共4页Chinese Journal of Practical Surgery

基　　金：国家自然科学基金项目(No.82372792);福建省自然科学基金项目(No.2023J05294)。

摘　　要：目的讨论“背驮式”食管空肠Overlap吻合术在全腔镜全胃切除术中的可行性和安全性。方法采用描述性系列研究方法,回顾性收集复旦大学附属中山医院胃肠外科2023年4月至2023年7月期间行“背驮式”食管空肠Overlap吻合术的6例胃上部癌病人的临床病理资料,分析病人术后恢复及术中、术后并发症情况。结果6例病人均成功实施全腹腔镜下全胃切除(背驮式食管空肠Overlap吻合),无中转开放手术。平均手术时间为(233.2±19.4)min;平均食管空肠吻合重建时间为(17.5±2.0)min;平均术中出血量为(68.5±17.5)mL。术后病人恢复良好,无吻合口相关并发症;1例病人因术后胸腔积液行介入超声下穿刺引流,总并发症发生率为16.7%。术后平均开放流质饮食时间为(2.7±0.4)d,术后平均住院时间为(6.7±0.4)d。结论“背驮式”食管空肠Overlap吻合术作为全腔镜全胃切除术后消化道重建方式便捷、安全、可行。Objective To discuss the feasibility and safety of the“piggyback”esophagojejunal Overlap anastomosis in total laparoscopic gastrectomy.Methods A descriptive series of research methods were used to retrospectively collect the clinical and pathological data of 6 patients with proximal gastric cancer who underwent“piggyback”esophagojejunal Overlap anastomosis in the Gastrointestinal Department of Zhongshan Hospital,Fudan University from April 2023 to July 2023.The postoperative recovery,intraoperative,and postoperative complications of the patients were analyzed.Results All 6 patients successfully underwent total laparoscopic gastrectomy(piggyback esophagojejunal Overlap anastomosis)without any conversion to open surgery.The mean surgical time was(233.2±19.4)minutes;The mean esophagojejunal anastomotic reconstruction time was(17.5±2.0)minutes and themean intraoperative bleeding volume was(68.5±17.5)mL.The postoperative patients recovered well without any complications related to the anastomosis;One patient underwent interventional ultrasound-guided drainage for postoperative pleural effusion,with a total complication rate of 16.7%.The mean time for a liquid diet after surgery was(2.7±0.4)days,and the mean postoperative hospitalization time was(6.7±0.4)days.Conclusion The“piggyback”esophagojejunal Overlap anastomosis is a convenient,safe,and feasible method for gastrointestinal reconstruction after total laparoscopic gastrectomy.

关 键 词：胃肿瘤 腹腔镜 食管空肠吻合 

分 类 号：R6[医药卫生—外科学]