Qian Yawei, Zhou Guang, Chang Feifei, Ping Xiaochun, Wang Guoliang
Department of General Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
Division of Gastric Surgery, Department of General Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
Front Surg. 2022 Oct 4;9:994659. doi: 10.3389/fsurg.2022.994659. eCollection 2022.
Although there were a variety of strategies for the alimentary tract reconstruction of patients with gastric cancer who underwent laparoscopic radical distal gastrectomy, it remains controversial regarding which procedure is optimal. We developed a simple technique for Roux-en-Y reconstruction during laparoscopic surgery and evaluated its technical feasibility and safety.
Seventy-one cases of modified Roux-en-Y reconstructions after laparoscopic radical distal gastrectomy were consecutively performed in our hospital, from November 2020 to March 2022. A retrospective review of medical data was conducted. Intraoperative and postoperative outcomes, including operation time and incidence of postoperative complications, were collected and analyzed.
All procedures of laparoscopic distal gastrectomy with D2 lymph node dissection were successfully completed without any intraoperative complication. The mean number of retrieved lymph node was 38.8 ± 10.6. Mean operative time was 223.5 ± 42.4 min, whereas intraoperative blood loss was 102.2 ± 96.3 ml. No postoperative mortality was recorded. Six patients (8.5%) experienced postoperative complications and were managed conservatively. In addition, only two patients (2.8%) required rehospitalization during a median short-term follow-up period of 6 months.
The modified method is a simple and safe approach for laparoscopic radical distal gastrectomy.
尽管对于接受腹腔镜根治性远端胃切除术的胃癌患者,消化道重建有多种策略,但哪种手术方式最佳仍存在争议。我们开发了一种在腹腔镜手术中进行Roux-en-Y重建的简单技术,并评估了其技术可行性和安全性。
2020年11月至2022年3月,我院连续对71例腹腔镜根治性远端胃切除术后行改良Roux-en-Y重建的患者进行了回顾性医疗数据审查。收集并分析了术中及术后结果,包括手术时间和术后并发症发生率。
所有腹腔镜远端胃切除术加D2淋巴结清扫术均成功完成,无术中并发症。平均清扫淋巴结数为38.8±10.6枚。平均手术时间为223.5±42.4分钟,术中出血量为102.2±96.3毫升。无术后死亡病例记录。6例患者(8.5%)出现术后并发症,经保守治疗。此外,在中位短期随访6个月期间,仅2例患者(2.8%)需要再次住院。
改良方法是一种简单、安全的腹腔镜根治性远端胃切除术方法。