改良关闭overlap吻合口共同开口方式在全腹腔镜根治性全胃切除术中的应用价值
Application value of modified closure of overlap anastomotic common opening in total laparoscopic radical gastrectomy
张万红 1麻宇超 1李林杰 1王振华 1任一鹏 1党学义 1史一楠2
作者信息
- 1. 中国医学科学院肿瘤医院山西医院肝胆胰胃外科,太原 030013
- 2. 中国医学科学院肿瘤医院消化内科,北京 100021
- 折叠
摘要
目的 探讨改良关闭overlap吻合口共同开口方式在全腹腔镜根治性全胃切除术中的应用价值.方法 采用回顾性描述性研究方法.收集2023年1月至2024年1月中国医学科学院肿瘤医院山西医院收治的39例行全腹腔镜根治性全胃切除术胃癌患者的临床病理资料;男27例,女12例;年龄为(61±9)岁.患者均行全腹腔镜根治性全胃切除术,消化道重建采用overlap吻合,并采用改良方式关闭overlap吻合口共同开口.正态分布的计量资料以(x)±s表示.计数资料以绝对数表示.结果 (1)术中和术后情况.39例患者均顺利施行全腹腔镜根治性全胃切除术,消化道重建方式均为overlap,术中均行改良关闭吻合口共同开口,无中转开腹手术,无开胸手术.患者手术时间为(210±52)min,术中出血量为(132±55)mL,淋巴结清扫数目为(23±11)枚,术后首次肛门排气时间为(3.3±0.3)d,术后首次进食流质饮食时间为(4.4±0.6)d,首次进食半流质饮食时间为(5.2±0.4)d,术后住院时间为(9.5±3.1)d.(2)并发症情况.39例患者中,7例发生围手术期并发症,其中Clavien-DindoⅡ级并发症5例、Ⅲ级并发症2例.并发症均经保守治疗后好转出院.(3)随访情况.39例患者上消化道造影检查结果均未显示吻合口漏情况,均获得术后1、3、6个月随访,随访期间无其他并发症、复发、转移、死亡情况发生.结论 改良关闭overlap吻合口共同开口方式运用于全腹腔镜根治性全胃切除术中,具有良好的安全性和近期疗效.
Abstract
Objective To investigate the application value of modified closure of overlap anastomotic common opening in total laparoscopic radical gastrectomy.Methods The retrospec-tive and descriptive study was conducted.The clinicopathological data of 39 patients with gastric cancer who underwent total laparoscopic radical gastrectomy in Shanxi Hospital of Cancer Hospital,Chinese Academy of Medical Sciences from January 2023 to January 2024 were collected.There were 27 males and 12 females,aged(61±9)years.All patients underwent total laparoscopic radical gastrectomy for gastric cancer,with gastrointestinal reconstruction using overlap anastomosis and a modified closure of overlap anastomotic common opening.Measurement data with normal distribu-tion were represented as Mean±SD,and count data were expressed as absolute numbers.Results(1)Intraoperative and postoperative conditions.All 39 patients underwent total laparoscopic radical gastrectomy for gastric cancer,with gastrointestinal reconstruction using overlap anastomosis and a modified closure of overlap anastomotic common opening successfully,without conversion to open surgery or thoracotomy.The operation time of 39 patient was(210±52)minutes,with the volume of intraoperative blood loss of(132±55)mL,number of lymph node dissected of 23±11.The time to postoperative first flatus of 39 patients was(3.3±0.3)days,with time to postoperative liquid food intake of(4.4±0.6)days,time to postoperative semi-liquid food intake of(5.2±0.4)days,and duration of postoperative hospital stay of(9.5±3.1)days.(2)Complications.Seven of the 39 patients experi-enced perioperative complications,including 5 cases with complication classified as Clavien-Dindo grade Ⅱ,and 2 cases with complication classified as Clavien-Dindo grade Ⅲ.After conservative treatment,all patients with complications improved and were discharged.(3)Follow-up.Results of upper gastrointestinal imaging of the 39 patients showed no anastomotic leakage,and all patients were followed up at 1,3,and 6 months after surgery.There was no other complications,tumor recur-rence and metastasis,or mortality during the follow-up period.Conclusion The modified closure of overlap anastomotic common opening in total laparoscopic radical gastrectomy has good safety and short-term efficacy.
关键词
胃肿瘤/全腹腔镜胃癌根治术/Overlap吻合/改良关闭共同开口/消化道重建Key words
Stomach neoplasms/Total laparoscopic gastrectomy for gastric cancer/Over-lap anastomosis/Modified closure of the common opening/Gastrointestinal reconstruction引用本文复制引用
基金项目
北京科创医学发展基金会青年项目(KC2023-JX-0186-FQ030)
出版年
2024
NETL
NSTL
万方数据