改良端端三角吻合在腹腔镜辅助左半结肠切除术的应用

doi:10.3877/cma.j.issn.2095-3224.2018.05.014

中华结直肠疾病电子杂志 ›› 2018, Vol. 07 ›› Issue (05) : 476 -479. doi: 10.3877/cma.j.issn.2095-3224.2018.05.014

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改良端端三角吻合在腹腔镜辅助左半结肠切除术的应用

王铁¹, 周海涛², 张帆³, 韩亚妹¹, 周志祥²^,^†(

)

^1. 061001　河北省沧州中西医结合医院胃肠外科
^2. 100021　北京，国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院结直肠外科
^3. 065000　廊坊，中国石油天然气集团公司中心医院普通外科

收稿日期:2017-10-22 出版日期:2018-10-25
通信作者: 周志祥

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

Tie Wang¹, Haitao Zhou², Fan Zhang³, Yamei Han¹, Zhixiang Zhou²^,^†()

^1. Department of Surgery, Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine of Hebei Province, Cangzhou 061000, China
^2. Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, Chinaa
^3. Department of General Surgery, China National Petroleum Corporation Central Hospital, Langfang 065000, China

Received:2017-10-22 Published:2018-10-25
Corresponding author: Zhixiang Zhou
About author:
Corresponding author: Zhou Zhixiang, Email: Zhouzx01@163.com

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引用本文：

王铁, 周海涛, 张帆, 韩亚妹, 周志祥. 改良端端三角吻合在腹腔镜辅助左半结肠切除术的应用[J/OL]. 中华结直肠疾病电子杂志, 2018, 07(05): 476-479.

Tie Wang, Haitao Zhou, Fan Zhang, Yamei Han, Zhixiang Zhou. Application of improved end-to-end delta-shaped anastomosis in laparoscopy-assisted left hemicolectomy[J/OL]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2018, 07(05): 476-479.

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。

关键词: 结肠肿瘤, 腹腔镜, 左半结肠, 改良端端三角吻合

Objective

To evaluate the application of improved end-to-end delta-shaped anastomosis in laparoscopy-assisted left hemicolectomy.

Methods

From 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.

Results

Sixty-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.

Conclusion

Improved end-to-end delta-shaped anastomosis is a safe and reliable digestive tract reconstruction after laparoscopy-assisted left hemicolectomy.

Key words: Colonic neoplasms, Laparoscopes, Left hemicolectomy, Improved end-to-end delta-shaped anastomosis

图3 直线切割吻合器吻合前壁后1/2

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