单孔+1腹腔镜全胃切除、D2淋巴结清扫术

因技术难度大、操作复杂及缺乏三角牵拉等原因,单孔+1腹腔镜全胃切除+D2淋巴结清扫+食管空肠吻合术存在技术上的挑战,目前尚未得到广泛应用。在此报道单孔+1腹腔镜全胃切除、D2淋巴结清扫术的初步经验。采用之前报道的单孔多通道通加1个戳孔(5 mm)的方式进行手术。全胃切除、D2淋巴结清扫的手术过程与传统腹腔镜手术方法相同。通过绕脐切口取出标本,使用体外空肠空肠吻合术和体内食管空肠吻合术完成Roux-en-Y重建(overlap)。手术时间198 min,出血量30 ml,没有观察到术中和术后并发症,清扫淋巴结数目50枚。术后排气时间、恢复流质饮食和住院时间分别为第2、4、7天。

Single port+1 laparoscopic total gastrectomy with D2 lymphadenectomy

Single port+1 laparoscopic total gastrectomy+D2 lymph node dissection+esophagojejunostomy has technical challenges due to technical difficulties,complex operation and lack of triangular traction,and has not been widely used at present.We report our preliminary experience with single-port+1 laparoscopic total gastrectomy and D2 lymph node dissection.The previously reported method of single port with multiple channels plus a trocar(5 mm)was used to perform the surgery.The procedure of total gastrectomy and D2 lymph node dissection is the same as that of traditional laparoscopic surgery.Specimens were extracted by incision around the umbilicus,and Roux-en-Y reconstruction(overlap)was completed by in vitro jejunojejunostomy and in vivo esophagojejunostomy.The operation time was 198min,the blood loss was 30ml,no intraoperative and postoperative complications were observed,and the number of dissected lymph nodes was 50.The duration of postoperative exhaust,recovery of fluid diet and hospitalization were 2,4,and 7 days,respectively.