摘要
目的 探讨双向缝合式食管空肠Overlap吻合在全腹腔镜全胃切除术中的应用价值。方法 回顾性收集2020年12月至2023年12月期间在成都市第三人民医院胃肠外科接受全腹腔镜全胃切除术的128例胃癌患者的临床病理资料。观察组采用双向缝合式食管空肠Overlap吻合法,对照组采用Overlap食管空肠侧-侧吻合,比较2组患者的疗效指标。结果 共纳入128例患者,其中观察组80例,对照组48例。观察组患者的术中吻合时间[(25.75±5.78)min比(29.43±2.73)min,P<0.001]、手术时间[(244.81±39.16)min比(257.18±44.36)min,P=0.037]、术后肛门排气时间[(2.30±0.80)d比(2.85±1.33)d,P=0.004]、术后住院时间[(7.15±2.10)d比(9.00±2.66)d,P<0.001]与对照组相比均减少。观察组术后有1例发生吻合口漏(Clavien-DindoⅡ级),经保守治疗后好转出院。所有患者获得随访,随访时间范围为术后1~12个月,随访时间中位数为12个月。随访期间出现4例死亡(观察组2例,对照组2例),均为非肿瘤性死亡,无其他并发症、复发及转移发生。结论 全腹腔镜全胃切除术中应用双向缝合式食管空肠Overlap吻合法是安全可行的,具有良好的近期疗效。
Objective To investigate the application value of bidirectional sutured esophagojejunal Overlap anastomosis in totally laparoscopic total gastrectomy(TLTG).Methods A retrospective analysis was performed on 128 patients with gastric cancer who underwent TLTG in the Department of General Surgery,The Third People’s Hospital of Chengdu/Clinical College of Southwest Jiaotong University·The Affiliated Hospital of Southwest Jiaotong University from December 2020 to December 2023.Patients in the observation group underwent bidirectional sutured esophagojejunal Overlap anastomosis,while patients in the control group received conventional Overlap side-to-side esophagojejunostomy.The two groups were then compared based on clinical outcome measures.Results A total of 128 patients were included,including 80 in the observation group and 48 in the control group.The intraoperative anastomosis time[(25.75±5.78)min vs(29.43±2.73)min,P<0.001],operative time[(244.81±39.16)min vs(257.18±44.36)min,P=0.037],time to postoperative flatus[(2.30±0.80)d vs(2.85±1.33)d,P=0.004],and postoperative hospital stay[(7.15±2.10)d vs(9.00±2.66)d,P<0.001]of the observation group were shorter than those in the control group.In the observation group,anastomotic leakage occurred in one patient(Clavien-Dindo gradeⅡ),who improved with conservative treatment and was discharged.All patients were successfully followed up after surgery,and the median follow-up time was 12 months.During follow-up,four deaths occurred(two in the observation group and two in the control group),all non-cancer-related.No other complications,recurrences,or metastases were observed.Conclusion Bidirectional sutured esophagojejunal Overlap anastomosis is safe and feasible in TLTG,providing favorable short-term effects.
作者
伍映鑫
杨信希
郭朋森
聂攀
刘雁军
WU Yingxin;YANG Xinxi;GUO Pengsen;NIE Pan;LIU Yanjun(Department of General Surgery,The Third People’s Hospital of Chengdu/Clinical College of Southwest Jiaotong University·The Affiliated Hospital of Southwest Jiaotong University,Chengdu 610031,P.R.China;College of Medicine,Southwest Jiaotong University,Chengdu 610031,P.R.China)
出处
《中国普外基础与临床杂志》
2025年第12期1543-1548,共6页
Chinese Journal of Bases and Clinics In General Surgery
基金
国家自然科学基金面上项目(项目编号:82470916)。
关键词
双向缝合式食管空肠Overlap吻合
胃癌
全腹腔镜全胃切除术
效果
bidirectional sutured esophagojejunal Overlap anastomosis
gastric cancer
total laparoscopic total gastrectomy
treatment outcome
