中国内镜杂志2023，Vol.29Issue(12)：72-78,7.DOI:10.12235/E20230021
不同吻合方法应用于腹腔镜全胃切除术食管空肠吻合重建中的对比研究
Comparative study of different anastomosis methods in laparoscopic total gastrectomy esophagus jejunum anastomosis reconstruction
龚磊 1喻晶 1覃相志 1李敏 1黄斌 1任明扬 1田云鸿 1彭洪2
作者信息
- 1. 南充市中心医院(川北医学院第二临床医学院) 胃肠外科,四川 南充 637000
- 2. 南充市中心医院(川北医学院第二临床医学院) 肛肠外科,四川 南充 637000
- 折叠
摘要
Abstract
Objective To investigate the safety and short-term efficacy of π-shaped anastomosis and circular anastomosis(reverse puncture device)in reconstruction of esophagojejunostomy after laparoscopic total gastrectomy.Methods A retrospective study was used to collect the clinical and pathological data of 75 cases of gastric cancer from January 2019 to March 2021.According to the different reconstruction methods of esophagojejunal anastomosis,the patients were divided into a linear cutting obturator group(π-shaped anastomosis group,n = 27)and a circular anastomat anastomosis group(reverse puncture device group,n = 48).The general information of the two groups,operation time,esophagojejunostomy time,intraoperative bleeding volume,number of intraoperative lymph node dissection,intraoperative complications,and postoperative complications were compared and analyzed.Results The operation time and esophagojejunostomy time in the π-shaped anastomosis group were(221.5±8.8)and(34.7±3.7)min,and the reverse puncture device group were and(246.9±5.6)and(47.2±4.6)min,respectively,the differences were statistically significant(t = 15.19,t = 11.81,P＜0.05).There were no statistical significance in the comparison of intraoperative bleeding volume and number of intraoperative lymph node dissection between the two groups(P＞0.05).In the reverse puncture device group,there were two intraoperative complications,including one case of esophageal jejunal anastomosis atresia and one case of anastomosis tear,postoperative complications occurred in 3 cases,postoperative anastomotic stenosis occurred in 2 case,and anastomotic bleeding occurred in 1 case.Conclusion Laparoscopic total esophagojejunostomy with π-shaped anastomosis and reverse puncture device are safe and feasible.In terms of esophagojejunostomy time,π-shaped anastomosis reconstruction time is shorter.When the small intestine diameter is relatively small and it is difficult to extend into the 25 mm stapler,the advantage of π-shaped anastomosis is more obvious.When the tumor is Siewert type Ⅰ and type Ⅱ adenocarcinoma of gastroesophageal junction,which infiltrates into above the dentate line,reverse puncture device method is recommended for reconstruction.关键词
胃肿瘤/腹腔镜全胃切除术/π形吻合/圆形吻合/反穿刺法Key words
gastric neoplasms/laparoscopic total gastrectomy/π-shaped anastomosis/circular anastomosis/reverse puncture device分类
医药卫生引用本文复制引用
龚磊,喻晶,覃相志,李敏,黄斌,任明扬,田云鸿,彭洪..不同吻合方法应用于腹腔镜全胃切除术食管空肠吻合重建中的对比研究[J].中国内镜杂志,2023,29(12):72-78,7.
