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| 自牵引后离断顺蠕动食管空肠吻合在全腹腔镜全胃切除术中的应用效果 |
| Application value of self-pulling and latter transection(SPLT)along peristaltic esophagojejunostomy in totally laparoscopic total gastrectomy |
| 投稿时间：2020-09-27 |
| DOI：10.3969/j.issn.1000-0399.2021.03.003 |
| 中文关键词: 全腹腔镜 胃癌根治术 自牵引 后离断 食管-空肠吻合 |
| 英文关键词: Total laparoscopy Radical gastrectomy Self-pulling Latter transection Esophagojejunostomy |
| 基金项目:安徽医科大学校科研基金项目（项目编号：2020xkj217） |
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| 中文摘要: |
| 目的 探讨自牵引后离断（SPLT）顺蠕动食管空肠吻合在全腹腔镜下全胃切除术中的应用效果。方法 回顾性分析2018年6月至2020年7月安徽医科大学附属巢湖医院胃肠外科43例行全腹腔镜下根治性全胃切除术患者的临床资料，根据术中食管-空肠的吻合方式，行SPLT顺蠕动吻合的20例患者作为SPLT组，行Overlap吻合的23例患者作为Overlap组。根据术中及术后情况，分析比较两组患者手术时间、食管-空肠吻合时间、术中出血量、淋巴结清扫数量、术后肛门恢复排气时间、术后并发症例数等指标的差异。结果 所有患者均予全腹腔镜下胃癌根治术并常规行D2清扫，无中转开腹。SPLT组患者手术时间为（162.48±18.34）min、食管空肠吻合时间为（26.12±5.38）min，均短于Ovelap组，差异有统计学意义（P<0.05）。两组患者术中出血量、淋巴结清扫数量、术后肛门恢复排气时间及术后并发症比较，差异无统计学意义（P>0.05）。结论 全腹腔镜下全胃切除术中SPLT顺蠕动吻合方式操作简单可靠，能明显缩短手术时间，预后恢复较好，临床值得推广。 |
| 英文摘要: |
| Objective To investigate the application value of self-pulling and latter transaction(SPLT) along peristaltic esophagojejunostomy in totally laparoscopic total gastrectomy. Methods The clinical data of 43 patients who underwent total laparoscopic radical gastrectomy in the Department of Gastrointestinal Surgery, Chaohu Hospital of Anhui Medical University from June 2018 to July 2020 were retrospectively analyzed. According to the intraoperative esophagojejunostomy, 20 patients underwent SPLT peristaltic anastomosis as SPLT group and 23 patients underwent overlap anastomosis as Overlap group. According to the intraoperative and postoperative conditions, the differences in operation time, esophagojejunostomy time, intraoperative blood loss, number of lymph node dissection, postoperative anal exhaust recovery time and postoperative complications between the two groups were analyzed and compared. Results All patients underwent laparoscopic radical gastrectomy and routine D2 dissection without conversion to laparotomy. The operation time of SPLT group was (162.48±18.34)min, esophagojejunostomy time was (26.12±5.38) min, which were shorter than those of Ovelap group, and the difference was statistically significant (P<0.05). There was no significant difference in intraoperative blood loss, number of lymph node dissection, postoperative anal exhaust recovery time and postoperative complications between the two groups (P>0.05). Conclusions The operation of SPLT peristaltic anastomosis in total laparoscopic gastrectomy is simple and reliable, which can significantly shorten the operation time and has a good prognosis. |
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