自牵引后离断技术在全腹腔镜全胃切除术中的应用  

Application of self-pulling latter transection technique in totally laparoscopic total gastrectomy

作　　者：江雯 郑磊 葛宇 汪晋[1] 丰茂坤 徐茂奇[1] 芮景 JIANG Wen;ZHENG Lei;GE Yu(Department of General Surgery,Wuhu Traditional Chinese Medicine Hospital Affiliated to Anhui College of Traditional Chinese Medicine,Wuhu 241000,China)

机构地区：[1]安徽中医药高等专科学校附属芜湖市中医医院普通外科,安徽芜湖241000

出　　处：《腹腔镜外科杂志》2024年第9期667-671,共5页Journal of Laparoscopic Surgery

基　　金：芜湖市卫健委科研项目(WHWJ2021y051);安徽省高校自然科学重点项目(KJ2021A1275)。

摘　　要：目的:探讨自牵引后离断食管空肠功能性端端吻合应用于全腹腔镜全胃切除术的临床效果。方法:选取2023年3月至2024年2月接受全腹腔镜全胃切除术(自牵引后离断吻合)的18例患者(观察组),并将2021年12月至2023年2月同一手术团队完成的20例腹腔镜全胃切除术(管型吻合)作为对照组,对比分析两组术中、术后情况及手术相关并发症发生率。结果:手术均顺利完成,切缘阴性,无围手术期死亡病例。观察组手术时间[(225.89±26.19)min vs.(244.65±22.05)min,P=0.022]、辅助切口长度[(6.06±1.00)cm vs.(10.20±1.06)cm,P<0.001]短于对照组,差异有统计学意义。两组术中出血量、淋巴结清扫数量、术后首次排气时间、术后住院时间、手术相关并发症发生率差异无统计学意义(P>0.05)。结论:自牵引后离断食管空肠功能性端端吻合应用于全腹腔镜全胃切除术安全可行,容易掌握,值得临床推广。Objective:To investigate the clinical effect of self-pulling latter transection functional end-to-end esophago-jejunostomy(SPLT-FETE)in totally laparoscopic total gastrectomy(TLTG).Methods:Eighteen patients who underwent SPLT-FETE TLTG from Mar.2023 to Feb.2024(observation group)were selected,and 20 patients who underwent laparoscopic total gastrectomy(circular anastomosis)performed by the same surgical team from Dec.2021 to Feb.2023 were selected as the control group.The intraoperative and postoperative conditions and the rates of surgery-related complications in the two groups were compared and analyzed.Results:The surgeries were successfully completed with negative incisal margins and no perioperative deaths.The operation time of the observation group was shorter than that of the control group[(225.89±26.19)min vs.(244.65±22.05)min,P=0.022],and the length of the auxiliary incision was shorter than that of the control group[(6.06±1.00)cm vs.(10.20±1.06)cm,P<0.001],and the differences were statistically significant.No significant difference was found in intraoperative blood loss,the number of lymph node dissected,the first postoperative venting time,postoperative hospital stay and the incidence of surgery-related complication between the two groups(P>0.05).Conclusions:The application of SPLT-FETE in TLTG is safe,feasible and easy to master,which is worthy of clinical p romotion.

关 键 词：胃肿瘤 全胃切除术 腹腔镜检查 自牵引后离断 食管-空肠吻合 

分 类 号：R735.2[医药卫生—肿瘤]