肠道去旋转手法在Treitz韧带附近肠道肿瘤手术中的应用

摘要

目的 探讨肠道去旋转手法在Treitz韧带附近肿瘤外科处理中应用的可行性.方法 回顾性分析2014年1月至2016年1月在吉林大学第二医院和中日联谊医院应用肠道去旋转手法进行外科手术处理的9例Treitz韧带附近肿瘤患者的临床资料. 结果 应用肠道去旋转手法成功切除9例患者的肿瘤,平均手术时间(195±50) min,其中肠道去旋转手法平均耗时为(19±5)min.9例患者未发生肠道去旋转手法相关副损伤,术中平均出血量(132±94) ml.术后2例患者发生胃瘫,1例患者发生术后早期梗阻,均经保守治疗后恢复.术后随访时间3 ～ 24个月,肿瘤复发2例,死亡1例,失访1例.结论 肠道去旋转手法在Trietz韧带附近胃肠肿瘤手术中的应用安全可行.%Objective To study the the feasibility of intestinal derotation maneuver in the resection of gastrointestinal neoplam localized in the vicinity of the ligament of Treitz.Method Intestinal derotation maneuver was applied in all the 9 case of gastrointestinal neoplasms near the ligament of Treitz,from January 2014 to January 2016,at the Second Hospital of Jilin University.The clinical date were retrospectively analyzed.Results Intestinal derotation maneuver were applied without failure in all the nine patients,the mean operation time were (195 ± 50) min,and the mean intestinal derotation maneuver time were (19 ±5) min;No derotation procedure-related injury occured,and the mean estimated blood loss were (132 ±94) ml.Early postoperative ileus developed in one case and gastroparesis in two cases.All were recovered by conservative treatment.The follow-up period were 3-24 month,tumor recurrence occurred in two cases and one case died.One case lossed to follow-up after postoperative 3 month.Conclusion The present data suggest that clinical use of intestinal derotation maneuver was feasible for surgical management of gastrointestinal neoplasms near the ligament of Treitz.