三孔法完全腹腔镜永久性粘膜管道式胃造口术

目的:总结三孔法完全腹腔镜永久性粘膜管道式胃造口术的手术经验与技巧。方法:回顾分析2010年8月至2012年10月为11例患者行三孔法完全腹腔镜永久性粘膜管道式胃造口术的临床资料,其中晚期食管癌9例,晚期贲门癌2例,均完全或几乎不能经口进食。结果:本组手术均获成功,无一例中转开腹;手术时间50～120 min,平均(55.0±22.5)min;术中出血量5～30 ml,平均(10.0±7.4)ml;术后住院3～9.5 d,平均(6.0±1.6)d。术后均无并发症发生,胃造口术后顺利开放并维持正常肠内营养。结论:三孔法完全腹腔镜永久性粘膜管道式胃造口术具有操作简便、微创、患者疼痛轻、康复快、启用造口早、安全可靠及舒适等优点,疗效满意,值得推广应用。

Three-port totally laparoscopic permanent gastrostomy with gastric mucosal pipeline

Objective:To summarize the operative experience and technique of three-port totally laparoscopic permanent gastrostomy with gastric mucosal pipeline.Methods:The clinical data of 11 patients who underwent three-port totally laparoscopic permanent gastrostomy with gastric mucosal pipeline from Aug.2010 to Oct.2012 were retrospectively analyzed.All of the 11 patients could hardly or almost could not take food orally,9 of whom were advanced esophageal cancer and 2 cases were advanced cardiac carcinoma.Results:All the operations were successfully accomplished and none was converted to laparotomy.The operative time was 50-120 min,mean(55.0±22.5) min;the intra-operative blood loss was 5-30 ml,mean(10.0±7.4) ml;the post-operative hospital stay was 3-9.5 d,mean(6.0±1.6) d.No complications occurred postoperatively.All stomas were successfully opened and normal enteral nutrition was maintained.Conclusions:Three-port totally laparoscopic permanent gastrostomy with gastric mucosal pipeline has advantages of easy operation,mini-invasion,little pain,fast recovery,early open of stoma,safety and comfort.The clinical results are satisfactory,and it deserves to be generalized.