全腔镜下吻合技术在腹腔镜胃癌根治术中的应用

目的 探讨全腔镜下吻合技术在腹腔镜胃癌根治术中的安全性及可行性.方法 回顾分析2012年7月-2013年7月吉林大学第二医院胃肠外科实施腹腔镜胃癌根治术全腔镜下吻合（36例,全腔镜吻合组）与小切口辅助吻合（47例, 小切口辅助组）患者的临床资料,并对两组临床资料进行对比分析.结果 83例患者均成功实施手术,无一例中转开腹.小切口辅助组切口长度为（7.1±0.9） cm,全腔镜吻合组为（2.6±0.4） cm.小切口辅助组吻合时间为（70.9±9.0） min,全腔镜吻合组为（29.1±4.9） min.术后小切口辅助组中度疼痛者6例,余41例为重度疼痛;全腔镜吻合组中度疼痛者29例,余7例为重度疼痛.小切口辅助组术后发生吻合口瘘1例,全腔镜吻合组未出现吻合口瘘及吻合口出血等并发症.结论 全腔镜下吻合技术在腹腔镜胃癌根治术中安全、可行,与小切口辅助吻合相比具有手术时间短和疼痛感减轻等优势.

Application of totally laparoscopic anastomosis in laparoscopic gastrectomy

Objective To explore the safety and feasibility of the total laparoscopic anastomosis in laparoscopic gastrectomy.Methods Clinical data of 36 patients who received totally laparoscopic anastomosis and another 47 patients who received anastomosis through small incision in our department from July 2012 to July 2013 were retrospectively analyzed.Clinical outcomes were compared between the two groups.Results The operation was successfully carried out in all the 83 patients.The mean incision length was （7.1 ±0.9） cm in small incision group and （2.6±0.4） cm in totally laparoscopic group,while the mean time of anastomosis was （70.9±9.0） min and （29.1± 4.9） min respectively.Six patients felt moderate pain and 41 felt severe pain in small incision group,while 29 patients felt moderate pain and 7 felt severe pain in totally laparoscopic group.Anastomotic leakage occurred in 1 case after operation in small incision group and there was no related anastomosis complication in totally laparoscopic group.Conclusions Total laparoscopic anastomosis is safe and feasible in laparoscopic gastrectomy for gastric cancer.Compared with small incision-assisted anastomosis,totally laparoscopic anastomosis is associated with shorter time and less pain.