CAJ | 학술논문

目的介绍新型经口底钉座置入装置(OrVil~(TM),Covidien)在腹腔镜胃切除食管-空肠或残胃管状吻合术中的应用,探讨其可行性、安全性及临床效果.方法对5例贲门、胃体癌患者及1例贲门部间质瘤患者分别施行腹腔镜下根治性全胃切除加食管-空肠Roux-en-Y吻合术以及近端胃次全切除加食管-残胃吻合术,用新型OrVil~(TM)装置经口将底钉座置入食管下端,进行食管-空肠或食管-残胃吻合.结果 6例患者手术均顺利,手术时间(183.3±25.8)min,术中出血(128.3±90.2)ml;术后(4.0±1.1)d恢复胃肠功能当天,行上消化道碘剂造影提示吻合口通畅无狭窄和瘘后开始进食,术后(9.0±2.6)d出院.术后28 d随访,患者一般情况良好,无吻合口狭窄等并发症发生.结论用OrVil~(TM)新型装置在食管内放置底钉座,行食管-空肠(残胃)管状吻合安全可靠,近期临床疗效佳.
목적 개소신형경구저정좌치입장치(OrVil~(TM),Covidien)재복강경위절제식관-공장혹잔위관상문합술중적응용,탐토기가행성、안전성급림상효과.방법 대5례분문、위체암환자급1례분문부간질류환자분별시행복강경하근치성전위절제가식관-공장Roux-en-Y문합술이급근단위차전절제가식관-잔위문합술,용신형OrVil~(TM)장치경구장저정좌치입식관하단,진행식관-공장혹식관-잔위문합.결과 6례환자수술균순리,수술시간(183.3±25.8)min,술중출혈(128.3±90.2)ml;술후(4.0±1.1)d회복위장공능당천,행상소화도전제조영제시문합구통창무협착화루후개시진식,술후(9.0±2.6)d출원.술후28 d수방,환자일반정황량호,무문합구협착등병발증발생.결론 용OrVil~(TM)신형장치재식관내방치저정좌,행식관-공장(잔위)관상문합안전가고,근기림상료효가.
Objective To report the newly developed reconstruction technique after laparoscopic total gastrectomy:intracorporeal circular stapling esophagojejunostomy using the transorally inserted anvil (OrVil~(TM);Covidien),and evaluate its feasibility,safety,and clinical outcomes.Methods After LTG (3 patients with gastric carcinoma in the body) or LPG(2 patients with gastric carcinoma in the cardiac and fundus,respectively,and 1 with cardiac stromal tumor),the anvil was then inserted transorally into the esophagus by using the OrVil~(TM) system.Double-stapling esophagojejunostomy or esophagogastrostomy with a circular stapler was performed intracorporeally.Results The operations were uneventful The operative time was (183.3±25.8) min,and blood loss was (128.3±90.2) ml.Postoperative fluorography revealed no anastomotic leakage or stenosis.Patients resumed an oral liquid diet on postoperative day (4.0±1.1),and were discharged on day (9.0±2.6).Patients were followed at 28 days and no complications were reported.Conclusions LTG with Roux-en-Y reconstruction or LPG with esophagogastrostomy using the OrVil~(TM) system appear to be safe and reliable with satisfactory shortterm outcomes.