Rangarajan M, Subramanian C S, Chandralathan T A
Rajah Muthiah Medical College and Hospital, Annamalai University, Annamalainagar 608002, India.
Surg Endosc. 2006 Jan;20(1):61-3. doi: 10.1007/s00464-005-0090-0. Epub 2005 Dec 7.
The aim of this study is to highlight the role of minimally invasive surgery in the form of laparoscopy-assisted truncal vagotomy (TV) with ante-colic posterior gastrojejunostomy (PGJ) for benign gastric outlet obstruction (GOO). GOO is relatively common in southern India due to various factors. From 1994 to 2004, 762 patients with GOO were operated on (open TV with PGJ) in our center.
From November 2003 to November 2004, 18 patients with GOO underwent the laparoscopic procedure in our unit. The procedure involves laparoscopic TV followed by the ante-colic PGJ performed extracorporeally through a 3.5-cm transverse incision in the upper abdomen.
The advantages of this procedure are that pain, hospital stay, size of wound, incidence of incisional hernia, and postoperative complications are reduced and the patient returns to work earlier. The results are comparable to those of a totally laparoscopic TV with PGJ.
This procedure is relatively easy to perform because the anastomosis is done extracorporeally, and it is less expensive than the use of endostaplers. Thus, more surgeons should be encouraged to perform laparoscopic TV with PGJ.
本研究的目的是强调腹腔镜辅助经腹迷走神经切断术（TV）联合结肠前胃空肠吻合术（PGJ）这种微创手术形式在治疗良性胃出口梗阻（GOO）中的作用。由于多种因素，GOO在印度南部相对常见。1994年至2004年，我院中心对762例GOO患者实施了手术（开放式TV联合PGJ）。
2003年11月至2004年11月，我院18例GOO患者接受了腹腔镜手术。该手术包括腹腔镜下TV，随后通过上腹部一个3.5厘米的横向切口在体外进行结肠前PGJ。
该手术的优点是疼痛减轻、住院时间缩短、伤口尺寸减小、切口疝发生率降低、术后并发症减少，且患者能更早恢复工作。结果与全腹腔镜TV联合PGJ相当。
该手术相对容易实施，因为吻合是在体外完成的，且比使用吻合器成本更低。因此，应鼓励更多外科医生开展腹腔镜TV联合PGJ手术。
