腹腔镜下空肠造瘘术69例病例分析
发布时间：2018-08-12 19:18
【摘要】：目的 分析腹腔镜下空肠造瘘术在微创食管手术中的安全性、可行性以及通过空肠造瘘管进行肠内营养支持的临床效果。 方法 回顾性分析浙江大学医学院附属第二医院胸外科2014年1月至2015年3月间行腹腔镜下空肠造瘘术的69例患者临床资料,其中男性58例,女性11例,平均年龄59.2岁,术前诊断为食管癌65例,其中63例为可根治性食管癌,于微创食管癌切除术中附加行空肠造瘘术,2例为晚期食管癌,仅单独行空肠造瘘术。1例自发性食管破裂,1例食管腐蚀伤,1例食管内异物致食管穿孔,1例食管平滑肌瘤均各自行相应手术及空肠造瘘术。 结果 67例患者均成功施行了腹腔镜下空肠造瘘术,有2例术中中转开腹。术后1例因心跳呼吸骤停死亡,1例出现不全性肠梗阻,1例出现腹壁感染。住院期间均未发生空肠造瘘管堵塞、移位、滑脱、断裂等情况。患者术后体重、体重指数较术前下降(P0.05)。通过空肠造瘘管滴入肠内营养液,患者术后第9天血清白蛋白浓度较术后第1天呈上升趋势(P0.05)。 结论 腹腔镜下空肠造瘘术在微创食管手术中是安全可行的,手术相关并发症发生率及死亡率低,在需经腹的微创食管手术中附加完成空肠造瘘术,可为食管疾病尤其是食管癌患者术后提供早期、长期的肠内营养支持,有利于患者的快速康复。
[Abstract]:Objective to analyze the safety and feasibility of laparoscopic jejunostomy in minimally invasive esophageal surgery and the clinical effect of enteral nutrition support through jejunostomy tube. Methods the clinical data of 69 patients undergoing laparoscopic jejunostomy from January 2014 to March 2015 in the second affiliated Hospital of Zhejiang University Medical College were retrospectively analyzed, including 58 males and 11 females, with an average age of 59.2 years. 65 cases of esophageal carcinoma were diagnosed before operation, 63 cases of which were radical esophageal carcinoma, 2 cases of advanced esophageal carcinoma were treated with jejunostomy during minimally invasive resection of esophageal carcinoma. Jejunostomy was performed only in 1 case of spontaneous esophageal rupture and 1 case of esophageal corrosion injury. One case of esophageal perforation caused by foreign body in esophagus and 1 case of esophageal leiomyoma were treated with corresponding operation and jejunostomy respectively. Results Laparoscopic jejunostomy was performed successfully in all 67 patients. One case died of cardiac and respiratory arrest after operation, 1 case had incomplete intestinal obstruction and 1 case had abdominal wall infection. There was no obstruction, displacement, slippage and rupture of jejunostomy tube during hospitalization. The body weight and body mass index of the patients after operation were lower than those before operation (P0.05). The concentration of serum albumin increased on the 9th day after operation compared with that on the first day after operation (P0.05). Conclusion Laparoscopic jejunostomy is safe and feasible in minimally invasive esophageal surgery with low incidence of complications and mortality. It can provide early and long term enteral nutrition support for patients with esophageal diseases, especially for patients with esophageal cancer.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R65
[Abstract]:Objective to analyze the safety and feasibility of laparoscopic jejunostomy in minimally invasive esophageal surgery and the clinical effect of enteral nutrition support through jejunostomy tube. Methods the clinical data of 69 patients undergoing laparoscopic jejunostomy from January 2014 to March 2015 in the second affiliated Hospital of Zhejiang University Medical College were retrospectively analyzed, including 58 males and 11 females, with an average age of 59.2 years. 65 cases of esophageal carcinoma were diagnosed before operation, 63 cases of which were radical esophageal carcinoma, 2 cases of advanced esophageal carcinoma were treated with jejunostomy during minimally invasive resection of esophageal carcinoma. Jejunostomy was performed only in 1 case of spontaneous esophageal rupture and 1 case of esophageal corrosion injury. One case of esophageal perforation caused by foreign body in esophagus and 1 case of esophageal leiomyoma were treated with corresponding operation and jejunostomy respectively. Results Laparoscopic jejunostomy was performed successfully in all 67 patients. One case died of cardiac and respiratory arrest after operation, 1 case had incomplete intestinal obstruction and 1 case had abdominal wall infection. There was no obstruction, displacement, slippage and rupture of jejunostomy tube during hospitalization. The body weight and body mass index of the patients after operation were lower than those before operation (P0.05). The concentration of serum albumin increased on the 9th day after operation compared with that on the first day after operation (P0.05). Conclusion Laparoscopic jejunostomy is safe and feasible in minimally invasive esophageal surgery with low incidence of complications and mortality. It can provide early and long term enteral nutrition support for patients with esophageal diseases, especially for patients with esophageal cancer.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R65
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1 尹路,陈桂明,钱{呓，
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