全腹腔镜下远端胃切除术并 Roux-en-Y 重建术。

Total laparoscopic distal gastrectomy with Roux-en Y reconstruction.

作者信息

Shim Jung Ho, Kim Jun Gi, Yoo Han Mo, Oh Seong Il, Jeon Hae Myung, Park Cho Hyun, Song Kyo Young

机构信息

Department of Surgery, Division of Gastrointestinal Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.

出版信息

Surg Laparosc Endosc Percutan Tech. 2013 Jun;23(3):349-53. doi: 10.1097/SLE.0b013e3182773db8.

DOI:10.1097/SLE.0b013e3182773db8

PMID:23752010

Abstract

PURPOSE

The aim of this study was to introduce our technique and evaluate the technical efficacy of Roux-en Y (RY) reconstruction after total laparoscopic distal gastrectomy (TLDG).

METHODS

We performed TLDG using our own method of RY-type anastomosis in a total of 38 consecutive patients with gastric adenocarcinomas and evaluated the techniques and postoperative outcomes.

RESULTS

The mean operative time was 144.5 ± 22.4 minutes, including reconstruction time, which was 26.2 ± 3.5 minutes. Most patients were of pathologic stage IA (76.3%) or IB (10.5%), 3 patients were of stage II, and 2 were of stage IIIA. The length of postoperative hospital stay was 8.3 ± 3.3 days (range, 5 to 20 d). Two cases required reoperation because of internal herniation. According to our endoscopic observation, bile reflux into the gastric remnant stump was not found.

CONCLUSIONS

TLDG with RY reconstruction is technically feasible in gastric cancer patients.

摘要

目的

本研究旨在介绍我们的技术，并评估全腹腔镜远端胃切除术（TLDG）后 Roux-en Y（RY）重建的技术疗效。

方法

我们采用自己的 RY 型吻合方法对 38 例连续性胃腺癌患者进行了 TLDG，并评估了技术及术后结果。

结果

平均手术时间为 144.5±22.4 分钟，包括重建时间，重建时间为 26.2±3.5 分钟。大多数患者为病理 IA 期（76.3%）或 IB 期（10.5%），3 例为 II 期，2 例为 IIIA 期。术后住院时间为 8.3±3.3 天（范围 5 至 20 天）。2 例因内疝需要再次手术。根据我们的内镜观察，未发现胆汁反流至胃残端。