中国普外基础与临床杂志

中国普外基础与临床杂志

全腔镜下远端胃癌根治术中空肠营养管置入方法体会

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目的 探讨全腔镜下远端胃癌根治术中空肠营养管的置入方法。 方法 回顾性分析 2017 年 10 月至 2018 年 3 月期间在兰州大学第二医院肿瘤外科住院并术前诊断为远端胃癌的 30 例患者的临床资料,所有患者均实施全腔镜下远端胃癌根治术并在术中置入空肠营养管,术中通过胃管引导,胃管与营养管的固定、分离,在直视下置入空肠营养管。 结果 30 例患者均成功实施全腔镜下远端胃癌根治术均成功置管,置管时间 10~15 min,平均 13.5 min;空肠营养管留置时间 5~7 d,平均 6 d;术后 30 例患者均未发生出血、吻合口漏、吻合口梗阻、吻合口狭窄、肠漏、肠梗阻等相关并发症。 结论 全腔镜下远端胃癌根治术中空肠营养管的置入方法操作简单,术中及术后相关的并发症少,为改善胃癌患者术后的营养状况提供了有利的保障。

Objective To explore method of jejunum nutrition tube implantation in total laparoscopic radical gastrectomy for distal gastric cancer. Method The clinical data of 30 patients with distal gastric cancer underwent the total laparoscopic radical gastrectomy from October 2017 to March 2018 in the Department of Oncological Surgery, the Second Hospital of Lanzhou University were retrospectively analyzed, the total laparoscopic distal gastrectomy were performed in all the patients and the jejunum nutrition tube were implanted during the operation. Results Thirty patients with distal gastric cancer were successfully treated with the total laparoscopic radical gastrectomy and the jejunum nutrition tubes were implanted into under the total laparoscopy through the intraoperative guidance by the gastric tube, firstly fastening the nutrition tube to the gastric tube in vitro, and then separating them in vivo, finally the nutrition tube was smoothly implanted into the jejunum under the direct vision. The implantation time was 10 to 15 min with an average of 13.5 min. The jejunal nutrition tube retention time was 5 to 7 d with an average of 6 d. There were no complications such as the bleeding, anastomotic leakage, anastomotic obstruction, stenosis, intestinal leakage, intestinal obstruction, and other complications after the operation in the 30 patients. Conclusions Method of jejunum nutrition tube implantation in total laparoscopic radical gastrectomy for distal gastric cancer is easy to perform. Intraoperative and postoperative complications are few. It provides a favorable guarantee for improving postoperative nutritional status of patient with distal gastric cancer.

关键词: 全腔镜胃癌根治术; 远端胃癌; 肠内营养

Key words: total laparoscopic radical gastrectomy; distal gastric cancer; enteral nutrition

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