改良四吻合器技术在近端胃癌根治术中的应用

目的 探讨改良四吻合器技术在近端胃癌根治术中应用的可行性和安全性.方法 回顾性分析55例行近端胃癌根治术患者的临床资料,其中28例采用改良四吻合器技术（改良组）、27例采用传统吻合技术（传统组）进行食管残胃间空肠双＂S＂吻合.结果 两组均无手术死亡病例,病理切缘均阴性.改良组手术时间为（158±31）min,明显短于传统组的（195±42）min（P＜0.05）.两组均未出现吻合口狭窄、出血、瘘以及胃瘫、切口感染等早期严重并发症,在术后恢复方面两组差异无统计学意义（P＞0.05）.所有患者均获3个月至2年的随访,两组各有2例出现反流性食管炎（P＞0.05） 改良组与传统组分别有2例（7.1%）和8例（29.6%）出现残胃空肠吻合口炎（P＜0.05）.结论 改良四吻合器技术用于近端胃癌根治术中食管残胃间空肠双＂S＂吻合安全可行.

Application of modified quadruple stapling technique in radical proximal gastrectomy for gastric carcinoma

Objective To investigate the feasibility and safety of modified quadruple stapling technique in radical proximal gastrectomy for gastric carcinoma.Methods Medical records of 55 consecutive patients who underwent radical proximal gastrectomy for gastric cancer were analyzed retrospectively.Twenty-eight patients (modified group) undergoing modified quadruple stapling technique were compared to 27 patients (traditional group) who underwent traditional approach during the same period.Results There was no perioperative mortality.All the patients had negative pathological resection margin.The mean operative time in the modified group was significantly shorter than that in the traditional group [(158±31) min vs.(195±42) min,P＜0.05].There were no immediate complications such as stricture,bleeding or leakage at the anastomosis,gastroparesis,and wound infection.Postoperative recovery did not differ between the two groups (P＞0.05).During the followup(range:3 months-2 years),2(7.1%) patients in the modified group and 2(7.4%) in the traditional group developed reflux esophagitis (P＞0.05) and anastomotic inflammation occurred in 2 cases (7.1%)for the modified group and 8(29.6%) for the traditional group(P＜0.05).Conclusion Modified quadruple stapling technique is a feasible and safe method in radical proximal gastrectomy.