摘要
目的通过与传统腹腔镜辅助下荷包缝合对比，探讨经口输送钉砧系统（OrVil）在腹腔镜贲门癌治疗中的可行性及应用价值。方法回顾性分析2014年5—12月在腹腔镜辅助下行全胃根治切除术的45例贲门癌患者的临床资料（OrVil组20例，荷包缝合组25例），比较两组患者手术情况及术后相关并发症。结果两组患者的手术时间、术中出血量、清扫淋巴结数目相比差异均无统计学意义（均P〉0．05）。OrVil组切口长度和食管空肠吻合时间均短于荷包缝合组[（5±1）cm比（11±2）cm，t=-10．724，P〈0．01；（28±4）min比（39±5）min，t=-7．996，P〈0．01]。OrVil组术后首次排气时间、术后住院时间均短于荷包缝合组f（3．7±0．9）d比（4．4±1．0）d，t=-2．485．P=0．017；（13±5）d比（16±4）d，t=-2．184，P=0．035]。两组术后总并发症的发生率（OrVil组5例，荷包缝合组6例）相比差异无统计学意义（P=0．938）。结论经口输送钉砧系统在腹腔镜贲门癌根治术中行全胃切除患者的治疗上安全可行，近期疗效满意。
Objective To evaluate transoral Orvil EEA stapler （OrVil） procedure in laparoscopic total gastrectomy for cardiac carcinoma compared with conventional anvil head method （purse-string suture）. Methods From May 2014 to December 2014 20 cases were included into OrVil group, and 25 cases into purse-string suture group. Results The two groups had sirrfilar mean numbers of dissected lymph nodes [ （ 25 ± 3 ） vs. （24 ±4）, t = 1. 067, P = 0. 2921, the mean time of operation, intraoperative blood loss, and postoperative complications （5 vs. 6, P = 0. 938 ）. The length of incision was significantly shorter [ （5 1 ） cm vs. （ 11 ±2） cm, t = - 10. 724, P 〈0. 01 ] and the esophagojejunostomy time was significantly less [ （ 28 ± 4） min vs. （ 39 ± 5 ） min, t = - 7. 996, P 〈 0. 01 ] with the use of OrVil. The time to first flatus and postoperative hospital stay were （3.7 ± 0. 9） d vs. （4.4 ± 1.0） d, t = - 2. 485, P = 0. 017 and （ 13 ± 5 ） d vs. （16 ± 4） d, t = -2. 184, P = 0. 035. Conclusions OrVil is a technically safe and feasible surgical procedure for esophagojejunostomy in laparoseopy assisted total gastrectomy in the treatment of cardiac carcinoma.
出处
《中华普通外科杂志》
CSCD
北大核心
2016年第8期639-642,共4页
Chinese Journal of General Surgery
关键词
胃肿瘤
胃切除术
腹腔镜
Stomach neoplasms
Gastrectomy
Laparoscopes
