改良端端三角吻合在腹腔镜辅助左半结肠切除术的应用

目的探讨改良端端三角吻合在腹腔镜辅助左半结肠切除术中的应用。 方法回顾性分析2015年6月至2017年6月行腹腔镜辅助左半结肠切除术并行改良端端三角吻合的62例结肠癌患者的临床资料，观察总手术时间、改良三角吻合手术时间、术中出血量、术后排气时间、术后住院天数、清除淋巴结数目及Clavien-Dindo分级等指标。 结果62例患者均行腹腔镜辅助左半结肠切除术，并接受结肠-结肠改良端端三角吻合，平均总手术时间为（135.77±48.63）min；改良端端三角吻合时间为（9.58±1.78）min；平均出血量为（43.25±20.75）ml；术后排气时间为（3.92±0.71）天；术后平均住院日为（6.42±2.89）天；术后清除淋巴结平均数量（23.55±10.85）枚；62例患者中发生吻合口漏1例、肠梗阻1例，切口感染1例，切口裂开2例，无吻合口出血、淋巴漏等并发症出现，Clavien-Dindo Ⅰ级3例，Ⅱ级1例，Ⅲb级1例。 结论改良端端三角吻合是腹腔镜辅助左半结肠切除术后又一安全、可靠的消化道重建方式。

Application of improved end-to-end delta-shaped anastomosis in laparoscopy-assisted left hemicolectomy

ObjectiveTo evaluate the application of improved end-to-end delta-shaped anastomosis in laparoscopy-assisted left hemicolectomy. MethodsFrom June 2015 to June 2017, retrospective analysis of sixty-two patients with clinical data of laparoscopy-assisted left hemicolectomy and improved end-to-end delta-shaped anastomosis, the data of these patients to be assessed value of this technique. ResultsSixty-two patients were all performed by laparoscopy-assisted left hemicolectomy and improved end-to-end delta-shaped anastomosis. The average total operative time was (135.77±48.63) min; improved end-to-end delta-shaped anastomosis operative time was (9.58±1.78) min; the average bleeding volume was (43.25±20.75) ml; the average time from surgery to first flaut was (3.92±0.71) days; the average time from surgery to discharge was (6.42±2.89) days. The average number of lymph nodes were 23.55±10.85; the anastomotic fistula has two cases, the intestinal obstruction has two cases, the incision infection has one case, the abdominal incision dehiscence has two cases, there were no complications such as anastomotic bleeding and lymphatic fistula. There were three cases of Clavien-Dindo grade Ⅰ, one case of grade Ⅱ and one case of grade Ⅲb. ConclusionImproved end-to-end delta-shaped anastomosis is a safe and reliable digestive tract reconstruction after laparoscopy-assisted left hemicolectomy.