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find Keyword "双通道吻合" 2 results
  • Application of Dual-Channel Anastomosis of Residual Stomach and Jejunum in Radical Resection of Upper Gastric Cancer

    Objective To explore the value of dual-channel anastomosis of residual stomach and jejunum in radical resection of the upper gastric cancer. Methods Forty patients with upper gastric cancer had undergone proximal gastrectomy and dualchannel digestive tract reconstruction, including esophagus-jejunum side to side anastomosis, residual stomachjejunum anastomosis, and jejunum-jejunum anastomosis. Results The cutting margin away from tumor in all the cases was more than 5 cm and no carcinoma residual. The number of lymph nodes dissection was 21±6, reaching the requirement of D2 radical surgery. There was no case appearing complications such as anastomotic leakage, obstruction or bleeding. Barium meal examination after operation showed that most of barium was directly into the jejunum, the remaining went through the duodenum into the jejunum without gastroesophageal reflux. Followed up 6-30 months with average 18 months, there were no visible reflux esophagitis in all the cases, and only 1 case appeared minor dumping syndrome. The hemoglobin increased and the quality of life was satisfactory after operation. Conclusions In regard to dual-channel anastomosis of residual stomach and jejunum, resection range is reasonable, dissection scope accords with the protocol and residual stomach has a certain pouch effect. The anastomosis has a favorable prevention from reflux esophagitis and dumping syndrome and retains the duodenum pathway, so that improves the quality of patients’ life and is a relatively ideal digestive tract reconstruction.

    Release date:2016-09-08 10:55 Export PDF Favorites Scan
  • 单孔加一孔腹腔镜近端胃切除间置空肠残胃空肠双通道吻合术治疗早期胃癌的可行性分析

    目的探索经脐单孔加一孔全腹腔镜近端胃切除间置空肠残胃空肠双通道吻合术(single incision plus one port laparoscopic proximal gastrectomy with double-tract anastomosis,SILP-DT)治疗胃癌的手术可行性及近期手术安全性。方法回顾性分析2023年10月至2024年1月期间襄阳市中心医院胃肠外科行SILP-DT治疗的5例胃癌患者的临床资料。结果5例患者均为男性,平均年龄66岁,体质量指数平均22.1 kg/m2。胃镜检查提示食管胃结合部癌(Siewert Ⅱ或Ⅲ型),平均直径2.5 cm,TNM分期为cT1-2N0-1M0。5例患者行SILP-DT均顺利完成,手术时间(180.0±25.5)min,术中出血量(7.5±2.5)mL,术后第1天疼痛评分均为1~2分,术后首次肛门排气时间(56.6±16.0)h、恢复流质饮食时间(2.6±0.6)d,术后拔除胃管时间(3.6±0.6)d、拔除引流管时间(6.0±1.0)d,术后住院时间(7.8±0.8)d。术后病理均为胃腺癌,切缘均阴性,高分化1例、中分化3例、低分化1例,清扫淋巴结(22.4±3.8)枚/例,均无淋巴结转移。5例患者于术后1个月时在胃肠外科门诊行上消化道造影检查见吻合口均通畅,无造影剂反流入食管。术后无出血、吻合口漏及死亡发生,腹壁切口美容效果良好。随访截至2025年1月,无肿瘤复发转移。结论本组经脐SILP-DT术治疗5例早期胃癌结果提示,该手术有微创优势,方法技术上可行、近期手术安全。

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