【摘要】 目的探讨腹腔镜袖状胃切除术三步法游离胃底安全性。方法选取2012年10月至2015年8月在我院接受腹腔镜袖状胃切除术的20例患者作为研究对象。随机将患者分成两组,常规组12例,改良组8例。比较两组胃底游离时间、术中出血量,术中脾损伤、术后胃漏、肛门排气时间、GERD(>30天)发生情况。结果两组术后均无胃漏发生。常规组术中脾上极撕裂损伤发生率17%(2/12),改良组无发生脾上极损伤。常规组GERD大于30天发生率41%(5/12),改良组GERD大于30天发生率33%(2/8),两组术后肛门排气时间无统计学意义(P>0.05),而术中胃底游离时间和术中出血量有统计学意义(P<0.05)。结论腹腔镜袖状胃切除术"三步法"游离胃底具有一定的优势,能减少脾脏损伤、缩短手术时间,不增加并发症的风险。更多还原

【Abstract】 Objective To investigate the laparoscopic sleeve gastrectomy three step free gastric security. Methods From October 2012 to August 2015 20 cases underwent laparoscopic sleeve gastrectomy patients in our hospital as the research object. The patients were random Ly divided into two groups, 12 cases in the conventional group and 8 cases in the modified group. Compared the free time of the two groups, the amount of bleeding during operation, spleen injury, postoperative gastric leakage, anal exhaust time, GERD(30 days). Results No gastric leakage occurred in the two groups after operation. In the conventional group, the incidence of splenic injury was 17%(2/12), and there was no splenic injury in the modified group. Conventional GERD group more than 30 day incidence of 41%(5/12), the improvement in GERD group more than 30 day incidence rate of 33%(2/8), two groups of postoperative anal exhaust time no statistical significance(P>0.05), and intraoperative gastric fundus free time and intraoperative blood loss was statistically significant(P<0.05). Conclusion Laparoscopic sleeve gastrectomy "three-step" free gastric fundus has certain advantages, can reduce spleen injury and shorten operative time, does not increase the complication risk.更多还原