PDF(Pubmed)
Abstract：
The placement of a jejunostomy catheter during esophagectomy may cause postoperative bowel obstruction. The proximity of the jejunostomy site to the midline might be associated with bowel obstruction, and we have introduced laparoscopic jejunostomy (Lap-J) to reduce jejunostomy\'s left lateral gap. We evaluated 92 patients who underwent esophagectomy for esophageal cancer between February 2013 and August 2022 to clarify the benefits of Lap-J compared to other methods. The patients were classified into two groups according to the method of feeding catheter insertion: jejunostomy via small laparotomy (J group, n = 75), and laparoscopic jejunostomy (Lap-J group, n = 17). Surgery for bowel obstruction associated with the feeding jejunostomy catheter (BOFJ) was performed on 11 in the J group. Comparing the J and Lap-J groups, the distance between the jejunostomy and midline was significantly longer in the Lap-J group (50 mm vs. 102 mm; P < 0.001). Regarding surgery for BOFJ, the distance between the jejunostomy and midline was significantly shorter in the surgery group than in the non-surgery group (43 mm vs. 52 mm; P = 0.049). During esophagectomy, Lap-J can prevent BOFJ by placing the jejunostomy site at the left lateral position to the midline and reducing the left lateral gap of the jejunostomy.
摘要：
食管切除术期间放置空肠造口术导管可能会导致术后肠梗阻。空肠造口术部位靠近中线可能与肠梗阻有关，我们引入了腹腔镜空肠造口术（Lap-J）以减少空肠造口术的左侧间隙。我们评估了2013年2月至2022年8月期间接受食管癌切除术的92例患者，以阐明与其他方法相比，Lap-J的益处。根据喂食导管插入的方法将患者分为两组：通过小剖腹手术进行空肠造口术（J组，n=75),和腹腔镜空肠造口术(Lap-J组，n=17）。在J组中，有11例进行了与饲用空肠造口术导管（BOFJ）相关的肠梗阻手术。比较J组和Lap-J组，在Lap-J组中，空肠造口术与中线之间的距离明显更长（50mmvs.102毫米;P<0.001)。关于BOFJ的手术，手术组的空肠造口术与中线之间的距离明显短于非手术组（43mmvs.52mm;P=0.049)。在食管切除术中,lap-J可以通过将空肠造口术部位放置在中线的左侧位置并减少空肠造口术的左侧间隙来预防BOFJ。
