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经腹腔镜辅助全胃切除术后应用经口内置钉座(OrVil)。

Application of the transorally inserted anvil (OrVil) after laparoscopy-assisted total gastrectomy.

机构信息

Department of Surgery, Gastroenterological Center, Yokohama City University, 4-57, Urafunecho, Minami-ku, Yokohama 232-0024, Japan.

出版信息

Surg Endosc. 2011 Apr;25(4):1300-5. doi: 10.1007/s00464-010-1367-5. Epub 2010 Oct 17.

Abstract

BACKGROUND

Laparoscopy-assisted total gastrectomy (LATG) is not a commonly performed procedure due to the surgical difficulty associated with reconstruction. Although various reconstruction methods have been reported, a standard technique has not yet been established. In this study, we compared the short-term outcomes of LATG reconstructed by mini-laparotomy and by the newly developed transorally inserted anvil (OrVil).

METHODS

From April 2006, a series of 45 patients underwent LATG. Of these, 15 were reconstructed by mini-laparotomy and 30 by OrVil. Short-term outcomes were compared between the two groups.

RESULTS

Operation time was significantly shortened and intraoperative blood loss significantly reduced by the use of OrVil. The postoperative course, including morbidity, did not differ between the two groups.

CONCLUSIONS

LATG using OrVil for the treatment of early gastric cancer is a technically feasible surgical procedure with sufficient lymph node dissection, satisfactory early recovery, and acceptable morbidity. It will be necessary to perform this novel technique in a large number of patients to confirm its feasibility.

摘要

背景

由于重建相关的手术难度,腹腔镜辅助全胃切除术(LATG)并非常规开展的术式。虽然已经报道了各种重建方法,但尚未建立标准技术。在这项研究中,我们比较了经迷你腹腔镜和新开发的经口内置吻合器(OrVil)重建的 LATG 的短期结果。

方法

自 2006 年 4 月起,一系列 45 例患者接受了 LATG。其中,15 例经迷你腹腔镜重建,30 例经 OrVil 重建。比较了两组的短期结果。

结果

使用 OrVil 可显著缩短手术时间并减少术中出血量。两组的术后病程(包括发病率)无差异。

结论

对于早期胃癌,使用 OrVil 进行 LATG 是一种具有技术可行性的手术,可进行充分的淋巴结清扫,早期恢复令人满意,发病率可接受。需要对大量患者进行这项新技术,以确认其可行性。

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