腹腔镜胃底折叠抗反流术联合胃袖状切除术动物实验研究

发布时间：2019-05-19 19:30

【摘要】：目的观察腹腔镜胃底折叠抗反流手术联合胃袖状切除术对动物模型的可行性和安全性。方法 2013年12月至2014年5月在柯惠上海临床培训中心及奥林巴斯上海实验室对8只小猪行腹腔镜下保留部分胃底的胃袖状切除术联合食管裂孔疝修补术及不同类型胃底折叠术(包括Nissen、Toupet、Dor胃底折叠术)。记录术中情况、手术步骤、技术难点及注意事项等。结果成功完成小猪腹腔镜胃袖状切除术和食管裂孔疝缝合修补术8次,不同类型胃底折叠术24次,即Nissen胃底折叠术、Toupet胃底折叠及Dor胃底前折叠术各8次。无一例中转开腹,所有实验动物均在手术中生命体征保持平稳,平均手术时间为(120.2±13.7)min,出血量为5~80(35.8±11.1)m L。术中1只发生肝损伤出血,其余均未发生脏器损伤及吻合口漏。手术时间随着训练次数明显缩短。结论腹腔镜胃底折叠抗反流手术联合胃袖状切除术对小猪动物模型安全可行,可为临床医师提供极佳训练机会,有助于缩短学习曲线,可能成为治疗肥胖合并胃食管反流病或食管裂孔疝的新型抗反流手术方法。
[Abstract]:Objective to observe the feasibility and safety of laparoscopic gastric fundus folding and anti-reflux surgery combined with gastric sleeve resection in animal model. Methods from December 2013 to May 2014, 8 piglets were treated with laparoscopic sleeve resection combined with esophageal hiatal hernia repair in Ke Hui Shanghai Clinical training Center and Olympus Shanghai Laboratory. Fundus folding (including Nissen,) Toupet,Dor fundus folding). Record intraoperative conditions, surgical steps, technical difficulties and matters needing attention. Results Laparoscopic gastric sleeve resection and esophageal hiatal hernia suture repair were successfully performed in piglets 8 times, 24 different types of gastric fundus folding, namely, Nissen fundus folding, Toupet fundus folding 8 times and Dor anterior fundus folding 8 times. None of the animals were converted to laparotomy. The vital signs of all the experimental animals remained stable during the operation, and the average operation time was (120.2 卤13.7) min,. The bleeding volume was 5 卤80 (35.8 卤11.11) m L.). Liver injury and bleeding occurred in 1 patient, and no organ injury and anastomotic leakage occurred in the rest. The operation time was significantly shortened with the number of training. Conclusion Laparoscopic fundus folding and anti-reflux surgery combined with gastric sleeve resection is safe and feasible in the animal model of piglets. It can provide excellent training opportunities for clinicians and is helpful to shorten the learning curve. It may be a new method of anti-reflux surgery for obesity complicated with gastroesophageal reflux disease or hiatal hernia.
【作者单位】：新疆维吾尔自治区人民医院微创外科、疝及腹壁外科;
【分类号】：R699

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