三孔法完全腹腔镜胃/空肠造瘘术

目的：总结三孔法完全腹腔镜胃/空肠造瘘术的初步经验。方法：回顾分析2007年10月至2009年11月采用三孔法行完全腹腔镜胃/空肠造瘘术放置永久性胃/空肠造瘘管10例的临床资料,其中晚期食管癌1例,晚期贲门癌2例,晚期胃癌7例,均完全或几乎不能经口进食,行三孔法完全腹腔镜胃造瘘术3例,三孔法完全腹腔镜空肠造瘘术7例。结果：本组手术均获成功,无中转开放,手术时间45~110min,平均60min,术中出血5~15ml,平均8.5ml,术后住院5~11d,平均7.2d。术后均无并发症发生,造瘘管均顺利开放并维持正常肠内营养。结论：三孔法完全腹腔镜胃/空肠造瘘术放置胃/空肠造瘘管具有患者创伤小、康复快、启用造瘘管早等特点,临床效果满意,值得推广。

Three-port totally laparoscopic gastrostomy and jejunostomy

Objective:To summarize the primary experience of 3-port totally laparoscopic gastrostomy and jejunostomy.Methods:Clinical data of 10 patients treated with 3-port laparoscopic gastrostomy and jejunostomy from Oct.2007 to Nov.2009 were retrospectively analyzed.One case of late esophageal cancer,2 cases of late cardiac cancer,and 7 cases of late gastric cancer were included.All patients completely or almost couldn't get food from mouth.There were 3 cases of 3-port laparoscopic gastrostomy,and 7 cases of 3-port laparoscopic jejunostomy.Results:Operations were successfully completed in all cases without conversion to open surgery.The operative time was 45-110min(mean,60min),the blood loss during operation was 5-15ml,with an average of 8.5ml,and postoperative hospital stay was 5-11d(mean,7.2d).There were no postoperative complications.All fistula tubes were successfully opened and maintained normal enteral nutrition.Conclusions:The procedure of 3-port laparoscopic gastrostomy and jejunostomy for placement stomach and jejunum fistula tube has advantages of fewer traumas,faster recovery and earlier use of fistula tubes,the clinical results are satisfactory,and it deserves to be generalized.