改良四吻合器技术在近端胃癌根治术中的应用

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.

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