完全腹腔镜全胃切除术中食管空肠套叠与π形吻合安全性的比较
Comparison of the safety of esophagojejunal overlap and π-shaped anastomosis in totally laparoscopic total gastrectomy.
作者信息
Song Tongkun, Liu Maoxing, Xu Kai, Xing Jiadi, Guo Kechen, Qi Xinyu, Gao Pin, Tan Fei, Yao Zhendan, Zhang Nan, Yang Hong, Zhang Chenghai, Cui Ming, Su Xiangqian
机构信息
Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Gastrointestinal Surgery IV, Peking University Cancer Hospital & Institute, Beijing, 100142, China.
State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers, Beijing Key Laboratory of Carcinogenesis and Translational Research, Department of Gastrointestinal Surgery IV, Peking University Cancer Hospital & Institute, No.52 Fucheng Road, Haidian District, Beijing, 100142, China.
出版信息
BMC Surg. 2025 Jan 14;25(1):24. doi: 10.1186/s12893-024-02703-w.
BACKGROUND
Globally, totally laparoscopic total gastrectomy is increasingly being accepted by surgeons for the treatment of gastric cancer. Overlap anastomosis and π-shaped anastomosis are the two most commonly used anastomosis methods in total laparoscopic surgery; however, their safety and suitability for the population are still unclear.
METHODS
A total of 162 consecutive patients with gastric cancer who underwent total laparoscopic total gastrectomy with overlap or π-shaped anastomosis were retrospectively analyzed. The intraoperative conditions and postoperative complications were compared.
RESULTS
A significant difference in the tumor location was found between the two groups (p < 0.05). No significant difference was found in the operation time, intraoperative blood loss, and postoperative hospital stay between the two anastomosis methods (p > 0.05); however, the π-shaped anastomosis group had more postoperative anastomotic leakage (p < 0.05).
CONCLUSIONS
Overlap anastomosis is recommended as the preferred anastomosis for totally laparoscopic total gastrectomy, and π-shaped anastomosis can be applied to non-gastroesophageal junction cancer with lower tumor location.
背景
在全球范围内，全腹腔镜全胃切除术越来越被外科医生接受用于治疗胃癌。重叠吻合术和π形吻合术是全腹腔镜手术中最常用的两种吻合方法；然而，它们的安全性及对人群的适用性仍不明确。
方法
回顾性分析162例连续接受全腹腔镜全胃切除术并行重叠或π形吻合术的胃癌患者。比较术中情况及术后并发症。
结果
两组间肿瘤位置存在显著差异（p<0.05）。两种吻合方法在手术时间、术中出血量及术后住院时间方面未发现显著差异（p>0.05）；然而，π形吻合术组术后吻合口漏更多（p<0.05）。
结论
推荐重叠吻合术作为全腹腔镜全胃切除术的首选吻合方式，π形吻合术可应用于肿瘤位置较低的非胃食管交界癌。
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