[1]张正红,葛明建*①,杨彦,等.腹腔镜下空肠拖出造瘘在胸、腹腔镜食管癌切除术后营养支持治疗中的应用[J].中国微创外科杂志,2017,17(10):936-938.
　Zhang Zhenghong*,Ge Mingjian,Yang Yan*,et al.Application of Laparoscopic Jejunum Pull Through Ostomy in Nutritional Support After Thoracolaparoscopic Resection of Esophageal Carcinoma[J].Chinese Journal of Minimally Invasive Surgery,2017,17(10):936-938.
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腹腔镜下空肠拖出造瘘在胸、腹腔镜食管癌切除术后营养支持治疗中的应用()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
17
期数:
2017年10期
页码:
936-938
栏目:
经验交流
出版日期:
2017-10-20

文章信息/Info

Title:
Application of Laparoscopic Jejunum Pull Through Ostomy in Nutritional Support After Thoracolaparoscopic Resection of Esophageal Carcinoma
作者:
张正红; 葛明建*①; 杨彦; 郑剑; 刘春盛; 夏杨凡（重庆市巴南区第二人民医院胸外科; 重庆400054）
重庆市巴南区第二人民医院胸外科，重庆400054
Author(s):
Zhang Zhenghong*;  Ge Mingjian;  Yang Yan*;  et al.
*Department of Thoracic Surgery, Second People’s Hospital of Chongqing Banan District, Chongqing 400054, China
关键词:
空肠造瘘; 腹腔镜; 食管癌; 营养支持
Keywords:
Jejunostomy; Laparoscopy; Esophageal carcinoma; Nutritional support
文献标志码:
B
摘要:
目的探讨胸、腹腔镜食管癌根治术同期行空肠拖出造瘘的可行性，及其在术后营养支持治疗中的应用价值。方法2013年7月~2016年12月，在78例胸、腹腔镜食管癌切除术中，腹腔镜下空肠定位并穿过标记牵引线，自剑突下切口拖出腹腔，置入鼻胃管行空肠造瘘，术后行肠内营养，观察术后情况。结果78例食管癌手术均同期完成空肠造瘘，造瘘平均耗时10 min（8~12 min）。2例造瘘孔腐蚀性皮炎，予以氧化锌换药治愈。3例初期腹泻，经灌注蒙脱石散后缓解。1例拔管困难，延迟至术后50天顺利拔管，其余77例保留造瘘管至术后1个月，无造瘘管堵塞、脱落及肠漏，无肠梗阻。结论腹腔镜下空肠拖出造瘘术，造瘘孔定位准确，操作简便，可应用于胸、腹腔镜食管癌切除术后营养支持。
Abstract:
ObjectiveTo explore the feasibility of jejunum pull through ostomy during thoracolaparoscopic resection of esophageal carcinoma and the value for postoperative nutritional support.MethodsFrom July 2013 to December 2016, there were 78 esophageal cancer patients who underwent thoracolaparoscopic resection. With the assistant of laparoscope, the jejunum was located and labelled with a traction stitch, and then was pulled through out the abdominal wall via the subxiphoid approach. A nasogastric tube was inserted and the jejunostomy was performed. Postoperative enteral nutritional support was conducted.ResultsAll the patients underwent jejunostomy during resection of esophageal carcinoma, with a mean time of jejunostomy of 10 min (range, 8-12 min). Two patients suffered from erosive dermatitis and were cured with zinc oxide dressing. Three patients had diarrhea and were relieved with montmorillonite powder irrigation. The ostomy tube could not be removed in 1 case and was given delayed removal at 50 days after operation. In the other 77 patients, the tube was retained for 1 month after operation. There were no complications such as tube obstruction, dropping, leakage, or intestinal obstruction.ConclusionLaparoscopic jejunum pull through ostomy has advantages of accurate orientation and simple performance for patients with esophageal cancer, being of value in the postoperative nutritional support.

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备注/Memo

备注/Memo:
*通讯作者，E-mail：mingjian_ge@126.com①（重庆医科大学附属第一医院胸外科，重庆400016）
更新日期/Last Update: 2018-01-11