经腹腔镜辅助全胃切除术后，采用经口插入吻合器（OrVil）行 Roux-en-Y 重建术治疗胃近端恶性肿瘤的一种安全吻合技术。

A safe anastomotic technique of using the transorally inserted anvil (OrVil) in Roux-en-Y reconstruction after laparoscopy-assisted total gastrectomy for proximal malignant tumors of the stomach.

机构信息

Department of Gastric Surgery, Fujian Medical University Union Hospital, No 29 Xinquan Road, Fuzhou 350001, Fujian Province, China.

出版信息

World J Surg Oncol. 2013 Oct 4;11:256. doi: 10.1186/1477-7819-11-256.

BACKGROUND

To explore the safety and feasibility of the transorally inserted anvil (OrVil) in laparoscopy-assisted total gastrectomy for gastric cancer.

METHODS

From December 2010 to June 2011, a total of 28 patients underwent laparoscopy-assisted total gastrectomy with a Roux-en-Y-esophagojejunostomy anastomosis with OrVil. Perioperative treatments, intraoperative data, postoperative complications and hospital length of stay were evaluated.

RESULTS

There were no conversions to the open gastrectomy. The mean operation time was 143 minutes and the mean blood loss was 70 ml. Patients resumed an oral liquid diet on postoperative days 4 to 5. Two patients (7%) who suffered postoperative aspiration pneumonia were cured by conservative treatment. The median hospital length of stay was 9.6 days (8 to 11 days), with no inhospital mortalities. The median follow-up time was 14.8 months (12 to 18 months), and postoperative endoscopic examination revealed no anastomosis stenosis in patients who had dysphagia.

CONCLUSION

The use of the OrVil is technically feasible and relatively safe for Roux-en-Y reconstruction after laparoscopy-assisted total gastrectomy.

背景

探索经口置入吻合器（OrVil）在腹腔镜辅助全胃切除术中用于胃癌的安全性和可行性。

方法

从 2010 年 12 月至 2011 年 6 月，共有 28 例患者接受了腹腔镜辅助全胃切除及 Roux-en-Y 食管空肠吻合术，使用 OrVil。评估围手术期治疗、术中数据、术后并发症和住院时间。

结果

无中转开腹手术。平均手术时间为 143 分钟，平均出血量为 70 毫升。患者术后第 4 至 5 天开始口服液体饮食。2 例（7%）患者发生术后吸入性肺炎，经保守治疗治愈。中位住院时间为 9.6 天（8 至 11 天），无院内死亡。中位随访时间为 14.8 个月（12 至 18 个月），术后内镜检查发现有吞咽困难的患者吻合口无狭窄。