Intracorporeal Anastomosis Using a Lapra-Ty Clip in Laparoscopic Distal Gastrectomy: Initial Clinical Experiences
Intracorporeal Anastomosis Using a Lapra-Ty Clip in Laparoscopic Distal Gastrectomy: Initial Clinical Experiences
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DOI：
10.1089/lap.2010.0343
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发表时间：
2011-01-01
影响因子：
1.3
通讯作者：
Kim, Yong Jin
中科院分区：
文献类型：
--
作者：
Choi, Yoon Young;Kim, Yong Jin
目的：本研究的目的是评估在全腹腔镜远端胃切除术（TLDG）中Roux-en-Y胃空肠造口术中Lapra-Ty夹子（LTc）的有效性、可靠性和性能。材料与方法：2009年5月至2009年10月，我们对25例连续的早期胃癌患者行TLDG手术。采用endodo - gia进行两肠侧对侧吻合，LTc闭合入孔并行缝合。结果：胃空肠及空肠吻合术均无瘘、出血、狭窄。我们有一个单一的术中并发症，莱文管在胃空肠造口处卡住了，所以我们做了一个修正。总平均手术时间254.4 min（范围170 ~ 485），平均吻合时间49 min（范围30 ~ 110）。平均住院时间为7.9天（范围，5-17），术后平均流食时间为2.6天（范围，2-5）。结论：LTc用于肠吻合是安全有效的，尤其是TLDG用于人肠吻合，采用LTc可减少总手术次数。也许，最重要的是，它可以通过使TLDG更容易在胃癌中执行来弥补TLDG的缺点。
Aim: The aim of this study was to assess the efficacy, reliability, and performance of the Lapra-Ty clip (LTc) during intracorporeal Roux-en-Y gastrojejunostomy in a totally laparoscopic distal gastrectomy (TLDG).Materials and Methods: Between May 2009 and October 2009, we performed TLDG on 25 consecutive early gastric cancer patients. Two-bowel anastomosis was done intracorporeally in the side-to-side fashion using Endo-GIA, and closure of the entry hole was done by LTc with a running suture.Results: There were no postoperative leakages, bleeding, or strictures in the gastrojejunostomies and jejunojejunostomies. We had a single intraoperative complication where the Levin tube was jammed at the gastrojejunostomy site, so a revision was done. Total mean operation time was 254.4 minutes (range, 170-485) and mean anastomosis time was 49 minutes (range, 30-110). Mean hospital stay was 7.9 days (range, 5-17), and mean time to liquid diet was 2.6 days postoperatively (range, 2-5).Conclusion: The usage of LTc is safe and efficient for bowel anastomosis, especially TLDG in humans, and adoption of LTc may help to reduce overall operative times. Perhaps, most importantly, it can cover the disadvantages of TLDG by making TLDG more easily executable in gastric cancer.