Roh Chul Kyu, Han Sang-Uk
Department of Surgery, Ajou University School of Medicine, Suwon, Korea.
J Minim Invasive Surg. 2020 Mar 15;23(1):1-2. doi: 10.7602/jmis.2020.23.1.1.
The recent advancements in surgical techniques and perioperative care have improved postoperative morbidity and survival after gastric cancer surgeries. However, anastomotic leakage, the most serious complication post-gastrectomy, continues to occur. In esophageal and colorectal cancer surgeries, the omentum is used as a physical barrier and increases blood perfusion to prevent leakage to the anastomotic site. However, the use of the omentum as an anastomotic barrier after gastrectomy has not been reported yet. The authors aimed to evaluate the efficacy and safety of omental free-shaped flap reinforcement on the anastomosis and dissected area following reconstruction after gastrectomy for preventing and treating anastomotic leakage. They reported that omental free-shaped flap reinforcement on the anastomosis might prevent anastomotic leakage post-gastrectomy. The omental flap also prevented further deterioration when leakage occurred. However, anastomosis-related complications, such as anastomotic stenosis and delayed gastric emptying, after an omental patch technique need to be evaluated further.
手术技术和围手术期护理方面的最新进展改善了胃癌手术后的术后发病率和生存率。然而,吻合口漏这一胃切除术后最严重的并发症仍时有发生。在食管癌和结直肠癌手术中,网膜被用作物理屏障并增加血液灌注以防止吻合部位发生渗漏。然而,胃切除术后将网膜用作吻合屏障的情况尚未见报道。作者旨在评估游离网膜瓣加固对胃切除术后重建后的吻合口和解剖区域在预防和治疗吻合口漏方面的疗效和安全性。他们报告称,对吻合口进行游离网膜瓣加固可能预防胃切除术后的吻合口漏。当发生渗漏时,网膜瓣还可防止病情进一步恶化。然而,网膜补片技术后与吻合相关的并发症,如吻合口狭窄和胃排空延迟,仍需进一步评估。