Huang Chao, Zhao Jiefeng, Liu Zitao, Huang Jun, Zhu Zhengming
Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, China.
Front Oncol. 2020 Apr 21;10:575. doi: 10.3389/fonc.2020.00575. eCollection 2020.
Totally laparoscopic total gastrectomy (TLTG) not only is difficult to operate but also has high technical requirements and a long learning curve. Therefore, it has not been widely carried out yet, and esophagojejunostomy is one of its difficulties. Relevant studies have shown that intracorporeal hand-sewn esophagojejunostomy is safe, feasible and low-cost, but it is complicated and time-consuming and requires a high-suture technique. This study introduces a simple, safe and feasible hand-sewn technique. The clinical data of 32 patients with the esophageal suspension method for hand-sewn esophagojejunostomy (suspension group) after TLTG were collected from February 2018 to June 2019. During the same period, 32 patients with traditional hand-sewn esophagojejunostomy (traditional group) after TLTG were used as the control group. The operative time, anastomosis time, exhaust time and hospitalization time of the suspension group were shorter than those of the traditional group. The intraoperative blood loss in the suspension group was less than that in the traditional group. There were no postoperative complications associated with the suspension group. For those who have some experience in laparoscopic suture technique, the esophageal suspension method for hand-sewn esophagojejunostomy after TLTG is a simple, safe, and feasible suture technique.
完全腹腔镜全胃切除术（TLTG）不仅操作难度大，而且技术要求高，学习曲线长。因此，该手术尚未广泛开展，食管空肠吻合术是其中的难点之一。相关研究表明，体内手工缝合食管空肠吻合术安全、可行且成本低，但操作复杂、耗时，需要较高的缝合技术。本研究介绍一种简单、安全、可行的手工缝合技术。收集2018年2月至2019年6月期间32例行TLTG后采用食管悬吊法手工缝合食管空肠吻合术患者（悬吊组）的临床资料。同期，选取32例行TLTG后采用传统手工缝合食管空肠吻合术患者（传统组）作为对照组。悬吊组的手术时间、吻合时间、排气时间和住院时间均短于传统组。悬吊组术中出血量少于传统组。悬吊组未出现术后并发症。对于有一定腹腔镜缝合技术经验的人来说，TLTG后采用食管悬吊法手工缝合食管空肠吻合术是一种简单、安全、可行的缝合技术。
