十二指肠营养管在胸腹腔镜食管癌切除术中应用的临床分析

  目的  探讨十二指肠营养管在胸腹腔镜食管癌切除术中应用的安全性及可行性。  方法  总结分析重庆医科大学附属第一医院2011年3月至2012年9月73例食管癌患者在胸腹腔镜下行食管癌切除术术中放置十二指肠营养管的手术方法和临床资料。手术方法包括胸腔镜下游离食管、腹腔镜下游离胃、消化道重建等重要步骤。  结果  73例患者术中均顺利放置十二指肠营养管，全组手术时间180~410 min，平均时间273 min，其中放置十二指肠营养管平均时间27 min。术中出血量50~450 mL，平均出血量120 mL。全组无死亡病例。术后发生吻合口瘘2例，胃肠功能不适5例，均顺利出院。  结论  十二指肠营养管在胸腹腔镜食管癌切除术中应用安全、可行，值得推广应用。 

Clinical analysis of the application of duodenal feeding tube in thoracoscopy-and laparoscopy-guided esophagectomy for esophageal carcinoma

  Objective   This study was aimed to investigate the safety and feasibility of applying duodenal feeding tube in thoracoscopyand laparcoscopy-guided esophagectomy for esophageal carcinoma.   Methods   Clinical data of 73 esophageal carcinoma patients who underwent esophagectomy and received a duodenal feeding tube by thoracoscopy and laparoscopy from March 2011 to September 2012 were analyzed retrospectively. Modes of operation included the separation of the esophagus by thoracoscopy, separation of the stomach by laparoscopy, reconstruction of the digestive tract, and so on.   Results   A duodenal feeding tube was carefully placed at the site of esophagectomy of the patient. Operation time lasted from 180 min to 410 min, with an average of 273 min. The duodenal feeding tube was placed at 27 min into the operation. Intra-operative blood loss ranged from 50 mL to 450 mL, with an average of 120 mL. No post-operative death was encountered among the cases. After surgery, anastomotic fistula and gastrointestinal discomfort occurred in 2 and 5 of the 73 cases, respectively.   Conclusion   Placement of a duodenal feeding tube at the site of esophagectomy through thoracoscopy and laparoscopy is completely safe and feasible.