摘要
目的:总结腹腔镜胃癌根治术后吻合口瘘经腹腔镜手术与保守治疗两种途径的治疗经验,以提高对吻合口瘘的治疗水平。方法:选取2008年1月-2013年1月期间兰州军区总医院普通外科行腹腔镜胃癌根治术后1000例患者中发生食管空肠吻合口瘘5例、食管胃吻合口瘘9例、胃空肠吻合口瘘14例病人进行回顾性分析。结果:8例病人因病情较轻给予持续胃肠减压、引流管持续冲洗、补液、抗感染、营养支持等保守治疗后治愈。20例行腹腔镜二次手术,所有患者均治愈出院,行腹腔镜二次手术治疗组平均住院时间(30.95±3.50)d、发热时间(3.18±1.02)d较保守治疗组[(33.62±4.87)d、(3.88±1.38)d]无明显差异,抗生素使用时间、引流管拔除时间、住院总费用及体重减轻百分率等较保守组明显减少[(3.73±0.66)d vs(4.56±0.78)d、(18.30±1.53)d vs(21.50±2.27)d、(81586.79±3149.25)元vs(90518.48±7902.43)元、(12.41±1.85)%vs(15.89±4.01)%],存在统计学意义。结论:腹腔镜治疗胃癌根治术后吻合口瘘安全有效,具有创伤小、患者术后恢复快等优点。
Objective：To summarize our experience of laparoscopy and laparotomy in treatment of the anastomotic fistula after Laparoscopic radical gastrectomy,to improve ones level in the treatment of anastomotic fistula.Methods：Selected 1000 patients after laparoscopic radical gastrectomy in 2008 January-2013 January from General Surgery Department of General Hospital of Lanzhou Military Command,and 5 cases with esophagus-jejunum anastomotic fistula,9 cases with esophagus-stomach anastomotic fistula,14 patients with jejunum-anastomotic fistula.These 28 cases were analysed retrospectively.Results：8 patients not so serious were cure after giving conservative treatment such as continuous gastrointestinal decompression,drainage tube continuous washing,rehydration,anti-infection and nutrition supportting.20 patients underwent the second laparoscopic operation and all patients were cured.Group of acceptting second laparoscopic surgery treatment the average length of hospital stay was （30.95 ± 3.50） d,feve time （3.18 ± 1.02） d.Group of acceptting conservative treatment the average length of hospital stay and fever time was [（33.62 ± 4.87） d,（3.88 ± 1.38） d],there had no obvious difference between the two groups.The antibiotic use time and weight loss percentage in group of acceptting second laparoscopic surgery treatment was obviously lower than the group of acceptting conservative treatment [（3.73 ± 0.66） d vs （4.56 ± 0.78） d,（12.41 ± 1.85） % vs （15.89 ± 4.01） %],there was significant difference between the two groups.Conclusion：Laparoscopy in treatment of the anastomotic fistula after laparoscopic radical gastrectomy is safe,feasible,effective,less invasive and rapid recovery.
出处
《现代肿瘤医学》
CAS
2014年第11期2650-2652,共3页
Journal of Modern Oncology
基金
国家科技部
财政部科技惠民计划一项(编号:2012GS620101)
甘肃省科技重大专项项目(编号:2011GS04390)
关键词
胃癌
吻合口瘘
腹腔镜
gastric cancer
anastomotic fistula
laparoscopic
