杨鼎华 1李沣员 1汪未知 1刘宏达 1夏义文 1徐皓1
作者信息
- 1. 南京医科大学第一附属医院胃肿瘤中心,江苏 南京,210029
- 折叠
摘要
Abstract
Objective:To investigate the safety,feasibility,and short-term efficacy of robot-assisted proximal gastrectomy com-bined with arcuate tunnel seromuscular flap esophagogastrostomy.Methods:A single-center retrospective observational study was con-ducted.Five consecutive patients who underwent robot-assisted proximal gastrectomy with arcuate tunnel seromuscular flap esophagogas-trostomy from May 2025 to Oct.2025 were enrolled.On the basis of conventional tunnel esophagogastrostomy,the superior edge of the seromuscular flap was modified into an arcuate shape,while the inferior edge was maintained horizontal.Perioperative indicators(opera-tive time,blood loss,and postoperative complications)were recorded.Reflux symptoms,swallowing function,and nutritional status were evaluated preoperatively and at 1 month,3 months postoperatively using the reflux disease questionnaire,Stooler dysphagia grading,functional assessment of cancer therapy-general,and serum albumin level,respectively.The gastroscopy and upper gastrointestinal con-trast were performed 3 months after surgery to comprehensively evaluate the morphology and function of the anastomosis,as well as the patient's quality of life.Results:All 5 operations were completed successfully without conversion to open surgery.The mean operative time was(310.8±59.7)min,and the intraoperative blood loss was 50.0(0.0,75.0)mL.One case of Clavien-Dindo grade Ⅱ chylous leakage occurred during the perioperative period,with a complication rate of 20％,which was cured after conservative treatment;no anastomotic leakage,bleeding,or symptomatic stenosis occurred.At 3 months postoperatively,the reflux disease questionnaire score was(3.0±2.2),all patients were classified as Stooler grade Ⅰ,the total score of life quality was(87.2±16.0),and the serum albumin level was(42.4±2.5)g/L.Gastroscopy and radiography showed that the anastomosis was unobstructed without reflux esophagitis or ste-nosis.Conclusions:Robot-assisted proximal gastrectomy with arcuate tunnel seromuscular flap esophagogastrostomy has safe and feasi-ble short-term results.On the basis of retaining the blood supply advantage of tunnel anastomosis,it optimizes the inlet morphology through the arcuate configuration,showing potential advantages in synergistically controlling gastroesophageal reflux and preventing anas-tomotic stenosis,and has certain clinical application prospects.关键词
胃肿瘤/近端胃切除术/机器人手术/隧道吻合/抗反流/吻合口狭窄Key words
Stomach neoplasms/Proximal gastrectomy/Robotic surgical procedures/Tunnel anastomosis/Anti-reflux/Anasto-motic stenosis分类
医药卫生
