目的探讨β形Roux-en—Y吻合(β吻合)在全腹腔镜下远端胃癌根治术中的可行性和安全性.方法回顾性分析2014年1—5月间第四军医大学唐都医院开展的21例完全腹腔镜下远端胃癌根治术并8吻合患者的临床资料。结果21例患者均成功实施完全腹腔镜下的远端胃癌D2根治术并β吻合。手术时间(229.0±18.7)min,β吻合时间(27.5±4.2)min,术中出血量(91.0±38.3)ml。淋巴结清扫数(33.2±4.6)枚,上、下切缘距离分别为(5.9±0.4)cm和(3.2±0.8)cm,切缘均未见癌细胞残留。术后进流食时间(2.1±0.8)d,肛门排气时间(3.1±0.9)d,术后住院时间(5.9±2.4)d。术后卅现肺部感染1例,腹腔感染1例,无吻合口相关并发症发生。结论β吻合技术应用于全腹腔镜下远端胃癌根治术安全可行,近期疗效满意。
Objective To explore the technical feasibility, safety, and clinical efficacy of β-shaped Roux-en-Y reconstruction (β reconstruction) in totally laparoscopic distal gastrectomy (TLDG). Methods Clinical data of 21 patients with gastric cancer undergoing TLDG with β reconstruction from January 2014 to May 2014 were retrospectively analyzed. Results TLDG with β reconstruction was successfully performed in all the patients. The mean time of operation and β reconstruction was (229.0±18.7) rain and (27.5±4.2) min. The blood loss was (91.0±38.3) ml and number of dissected lymph node was 33.2±4.6 per patient. The length of upper and lower segment of resection from lesion was (5.9±0.4) cm and (3.2±0.8) era. The average time to resume fluid diet, time to restore flatus and hospital stay were (2.1±0.8) d, (3.1±0.9) d and (5.9±2.4) d, respectively. Conclusion The β reconstruction is a safe and feasible procedure for TLDG and provides satisfactory short-term efficacy.