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中华普外科手术学杂志(电子版) ›› 2025, Vol. 19 ›› Issue (01) : 1 -4. doi: 10.3877/cma.j.issn.1674-3946.2025.01.001.

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全腹腔镜下全胃切除术食管空肠吻合的临床研究进展
李国新1,2,(), 陈新华2   
  1. 1.102218 北京,北京清华长庚医院胃肠外科
    2.510515 广州,南方医科大学南方医院普通外科,广东省胃肠肿瘤精准微创诊疗重点实验室
  • 收稿日期:2024-09-01 出版日期:2024-12-25
  • 通信作者: 李国新
  • 基金资助:
    广东省胃肠肿瘤精准微创诊疗重点实验室(2020B121201004)

Progress of clinical research on esophagojejunal anastomosis after total laparoscopic gastrectomy

Guoxin Li1,2,(), Xinhua Chen2   

  1. 1.Department of General Surgery,Beijing Tsinghua Changgung Hospital,Beijing 102218,China
    2.Department of General Surgery & Guangdong Provincial Key Laboratory of Precision Medicine for Gastrointestinal Tumor,Nanfang Hospital,Southern Medical University,Guangzhou Guangdong Province 510515,China
  • Received:2024-09-01 Published:2024-12-25
  • Corresponding author: Guoxin Li
引用本文:

李国新, 陈新华. 全腹腔镜下全胃切除术食管空肠吻合的临床研究进展[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 1-4.

Guoxin Li, Xinhua Chen. Progress of clinical research on esophagojejunal anastomosis after total laparoscopic gastrectomy[J/OL]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2025, 19(01): 1-4.

全腹腔镜下全胃切除术是胃外科领域中技术难度最高的手术,其中食管空肠吻合目前仍存在较大的技术挑战,成为制约该技术发展的瓶颈,在一定程度上妨碍了其应用与普及。目前,临床常用的吻合方法主要包括管状吻合、直线切割吻合以及手工缝合。对于如何更高效、更安全地实现食管空肠吻合,是从事腹腔镜胃癌外科医师们亟需关注的临床议题。笔者回顾了全腹腔镜下全胃切除术中食管空肠吻合的临床研究进展,并结合个人临床实践与经验,探讨了食管空肠吻合技术的发展方向。

laparoscopic total gastrectomy, a complex procedure in gastric surgery, encounters technical difficulties with esophagojejunal anastomosis, which slows its progression and hinders its application.Currently, the most common methods for this anastomosis include circular stapler, linear stapler, and hand suturing anastomosis techniques.The challenge of achieving an efficient and safe esophagojejunal anastomosis is a pressing clinical issue for surgeons.This article reviews the progress of intracorporeal esophagojejunal anastomosis in laparoscopic total gastrectomy and proposes future directions based on personal experience and practice.

[1]
Yu J, Huang C, Sun Y, et al.Effect of Laparoscopic vs Open Distal Gastrectomy on 3-Year Disease-Free Survival in Patients With Locally Advanced Gastric Cancer: The CLASS-01 Randomized Clinical Trial[ J].JAMA, 2019, 321(20): 1983-1992.
[2]
李子禹,张效鹏,李双喜.不断提高腹腔镜胃癌全胃切除术的规范化[J/CD].中华普外科手术学杂志(电子版),2024,18(02): 119-123.
[3]
李子禹,王胤奎.腹腔镜全胃切除术后消化道重建术式选择与策略胃癌外科手术规范化[J/CD].中华普外科手术学杂志(电子版),2023, 17(04): 364-368.
[4]
Liu F, Huang C, Xu Z, et al.Morbidity and Mortality of Laparoscopic vs Open Total Gastrectomy for Clinical Stage I Gastric Cancer: The CLASS02 Multicenter Randomized Clinical Trial[ J].JAMA Oncol, 2020, 6(10): 1590-1597.
[5]
陈新华,罗俊,朱煜,等.腹腔镜全胃切除经口抵钉座置入装置腔内食管-空肠吻合与传统辅助切口吻合 安全性对比的倾向得分匹配分析[J].中华胃肠外科杂志,2018, 21(08):887-895.
[6]
Chen XH, Hu YF, Luo J, et al.The safety of esophagojejunostomy via a transorally inserted-anvil method vs extracorporeal anastomosis using a circular stapler during total gastrectomy for Siewert type 2 adenocarcinoma of the esophagogastric junction[ J].Gastroenterol Rep (Oxf), 2020, 8(3): 242-251.
[7]
陈新华,胡彦锋,林填,等.腹腔镜全胃切除术食管空肠经辅助切口圆形吻合与腔内吻合的安全性和有效性分析[J].中华胃肠外科杂志,2022, 25(05): 421-432.
[8]
Chen Y, Yang Z, Zhao M, et al.Impact of preoperative therapy on surgical outcomes of laparoscopic total gastrectomy for gastric/gastroesophageal junction cancer[ J].Chin J Cancer Res, 2023,35(4): 354-364.
[9]
Xinhua C, Tian L, Huilin H, et al.Application value of overlap guiding tube (OGT) in assisting overlap esophagojejunostomy during laparoscopic total gastrectomy for gastric/gastroesophageal junction (G/GEJ) tumor[sJ].Gastric Cancer, 2022, 25(4): 827-836.
[10]
Chen X, Lin T, Zhao M, et al.Safety and Efficacy of OGTAssisted Overlap Oesophagojejunostomy Versus the Traditional Overlap Method in Laparoscopic Total Gastrectomy for Gastric/Gastroesophageal Junction (G/GEJ) Tumour[sJ].Ann Surg Oncol,2023, 30(5): 2729-2738.
[11]
Xinhua C, Huilin H, Guoxin L, et al.ASO Author Reflections:OGT-Assisted Method Made the Overlap Esophagojejunostomy in Laparoscopic Total Gastrectomy Easie[rJ].Ann Surg Oncol,2023, 30(5): 2739-2740.
[12]
陈新华,胡彦锋,林填,等.Overlap引导管在腹腔镜全胃切除Overlap食管空肠吻合术中的应用价值[J].中华消化外科杂志,2022, 21(01): 99-105.
[13]
陈新华,李国新,张驰,等.胃癌围手术期并发症[J].中华胃肠外科杂志,2023, 26(02): 160-166.
[14]
陈新华,杨植景,许传金,等.与Overlap引导管配套的对接胃管在食管空肠吻合术中的应用价值[J].中华胃肠外科杂志,2023, 26(10): 986-989.
[15]
Usui S, Ito K, Hiranuma S, et al.Hand-assisted laparoscopic esophagojejunostomy using newly developed purse-string suture instrument “Endo-PSI”[J].Surg Laparosc Endosc Percutan Tech,2007, 17(2): 107-110.
[16]
Omori T, Oyama T, Mizutani S, et al.A simple and safe technique for esophagojejunostomy using the hemidouble stapling technique in laparoscopy-assisted total gastrectomy[J].Am J Surg, 2009,197(1): e13-e17.
[17]
Li X, Hong L, Ding D, et al.Comparison of OrVil and RPD in laparoscopic total gastrectomy for gastric cancer[ J].Surg Endosc,2017, 31(11): 4773-4779.
[18]
Chen D, Cheng P, Ding D, et al.Feasibility and safety of a novel reverse puncture device (RPD) for laparoscopic esophagogastrostomy/esophagojejunostomy[J].Int J Clin Exp Med, 2014, 7(9): 2497-2503.
[19]
池良杰,陈鸿源,王襄瑜,等.改良反穿刺法食管空肠吻合在全腹腔镜根治性全胃切除术中的应用[J].中华胃肠外科杂志,2024, 27(02): 182-188.
[20]
Jeong O, Park YK.Intracorporeal circular stapling esophagojejunostomy using the transorally inserted anvil (OrVil)after laparoscopic total gastrectomy[J].Surg Endosc, 2009,23(11): 2624-2630.
[21]
Marangoni G, Villa F, Shamil E, et al.OrVil-assisted anastomosis in laparoscopic upper gastrointestinal surgery: friend of the laparoscopic surgeon[ J].Surg Endosc, 2012, 26(3): 811-817.
[22]
Kunisaki C, Makino H, Oshima T, et al.Application of the transorally inserted anvil (OrVil) after laparoscopy-assisted total gastrectomy[ J].Surg Endosc, 2011, 25(4): 1300-1305.
[23]
Shim JH, Yoo HM, Oh SI, et al.Various types of intracorporeal esophagojejunostomy after laparoscopic total gastrectomy for gastric cancer[ J].Gastric Cancer, 2013, 16(3): 420-427.
[24]
Kawamura H, Ohno Y, Ichikawa N, et al.Anastomotic complications after laparoscopic total gastrectomy with esophagojejunostomy constructed by circular stapler (OrVilTM)versus linear stapler (overlap method)[ J].Surg Endosc, 2017,31(12): 5175-5182.
[25]
马胜杰,赵银泉,夏明杰,等.OrVilTM与Overlap食管空肠吻合在食管胃结合部腺癌腹腔镜根治性全胃切除术中的临床价值[J].中华消化外科杂志,2023, 22(03): 383-390.
[26]
Uyama I, Sugioka A, Fujita J, et al.Laparoscopic total gastrectomy with distal pancreatosplenectomy and D2 lymphadenectomy for advanced gastric cancer[ J].Gastric Cancer, 1999, 2(4): 230-234.
[27]
Kwon IG, Son YG, Ryu SW.Novel Intracorporeal Esophagojejunostomy Using Linear Staplers During Laparoscopic Total Gastrectomy: pi-Shaped Esophagojejunostomy, 3-in-1 Technique[ J].J Am Coll Surg, 2016, 223(3): e25-e29.
[28]
Inaba K, Satoh S, Ishida Y, et al.Overlap method: novel intracorporeal esophagojejunostomy after laparoscopic total gastrectomy[ J].J Am Coll Surg, 2010, 211(6): e25-e29.
[29]
So KO, Park JM.Totally laparoscopic total gastrectomy using intracorporeally hand-sewn esophagojejunostomy[J].J Gastric Cancer, 2011, 11(4): 206-211.
[30]
Umemura A, Koeda K, Sasaki A, et al.Totally laparoscopic total gastrectomy for gastric cancer: literature review and comparison of the procedure of esophagojejunostomy[J].Asian J Surg, 2015,38(2): 102-112.
[31]
Facy O, De Blasi V, Goergen M, et al.Laparoscopic gastrointestinal anastomoses using knotless barbed sutures are safe and reproducible: a single-center experience with 201 patients[ J].Surg Endosc, 2013, 27(10): 3841-3845.
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