七针定式缝合法在腹腔镜全胃切除食管空肠手工吻合中的应用  

Application of seven-stitch definitive suture in total laparoscopic total gastrectomy with esophagojejunostomy

作　　者：陆飞 刘鸿飞 王帅 张波[2] 赵忠扩 LU Fei;LIU Hongfei;WANG Shuai;Zhang Bo;ZHAO Zhongkuo(Department of General Surgery,The Fourth Affiliated Hospital,Zhejiang University School of Medicine,Yiwu,Zhejiang 322000,China;不详)

机构地区：[1]浙江大学医学院附属第四医院普外科,浙江省义乌市322000 [2]浙江大学医学院附属第二医院普外科

出　　处：《临床外科杂志》2024年第12期1268-1271,共4页Journal of Clinical Surgery

基　　金：国家自然科学基金科研资助项目(81570698)。

摘　　要：目的总结七针定式缝合法在腹腔镜全胃切除术联合食管空肠吻合中的应用体会。方法2021年3月~2022年7月收治的早期及进展期胃上部癌病人14例,均行腹腔镜全胃切除术,食管空肠吻合重建消化道,吻合采用七针定式缝合法优化手工吻合,分析手术时间、术中出血量、术中吻合重建费用、术后并发症、术后病理以及预后情况。结果14例病人手术平均时间为300分钟,术中平均出血量为110 ml,术中切除及重建所需耗材平均费用为16767元。14例病人中,有3例出现围术期并发症。结论七针定式缝合法与器械吻合比较,避免了因个体差异带来组织吻合张力过高及组织压榨风险,未增加术后并发症发生率,降低了病人的医疗费用,安全有效的优化腔镜手工吻合的进程。Objective To summarize the application of seven-stitch definitive suture in total laparoscopic total gastrectomy with esophagojejunostomy.Methods From March 2021 to July 2022,14 patients with early and advanced upper gastric cancer were treated with total laparoscopic total gastrectomy,esophagojejunal anastomosis to reconstruct digestive tract,and manual anastomosis was optimized by seven-stitch definitive suture method for anastomosis.The operative time,intraoperative blood loss,intraoperative anastomosis reconstruction cost,postoperative complications,postoperative pathology and prognosis were analyzed Results The average operation time of the 14 patients was 300 minutes,the average intraoperative blood loss was 110 ml,and the average cost of consumables for resection and reconstruction was 16767 yuan.Of the 14 patients,3 had perioperative complications.Conclusion Compared with instrument anastomosis,seven-stitch definitive suture avoids the risk of excessive tissue anastomosis tension and tissue compression caused by individual differences,does not increase the incidence of postoperative complications,reduces the medical cost of patients,and safely and effectively optimizes the process of endoscopic manual anastomosis.

关 键 词：胃癌 腹腔镜全胃切除术 食管空肠手工吻合术 

分 类 号：R73[医药卫生—肿瘤]