Experience of jejunum nutrition tube implantation in total laparoscopic radical gastrectomy for distal gastric cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

DING Tianlong ¹ , LIU Xiaolong ² , WANG Dan ² , MA Yanling ² , LI Xuemei ² , GU Baohong ² , CHEN Yajing ² , CUI Hongbin ¹ , DANG Jianzhong ¹ ,  CHEN Hao ¹

1. Departmeng of Tumor Surgery, Lanzhou University Second Hospital, Lanzhou 730030, P. R. China;
2. Lanzhou University Second School of Clinical Medicine, Lanzhou 730030, P. R. China;

Corresponding?author：

CHEN Hao, Email: chenhaodrs@163.com

Keywords：

total laparoscopic radical gastrectomy; distal gastric cancer; enteral nutrition

DOI：

10.7507/1007-9424.201807006

Video：

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Objective To explore method of jejunum nutrition tube implantation in total laparoscopic radical gastrectomy for distal gastric cancer (GC). Methods The clinical data of 30 patients with distal GC underwent the total laparoscopic radical gastrectomy from October 2017 to March 2018 in the Departmeng of Tumor Surgery, Lanzhou University Second Hospital were retrospectively analyzed, the total laparoscopic radical distal gastrectomy were performed in all the patients and the jejunum nutrition tube were implanted during the operation. Results Thirty patients with distal GC were successfully treated with the total laparoscopic radical gastrectomy and the jejunum nutrition tubes were implanted into under the total laparoscopy through the intraoperative guidance by the gastric tube, firstly fastening the nutrition tube to the gastric tube in vitro, and then separating them in vivo, finally the nutrition tube was smoothly implanted into the jejunum under the direct vision. The implantation time was 10 to 15 min with an average of 13.5 min. The jejunal nutrition tube retention time was 5 to 7 d with an average of 6 d. There were no complications such as the bleeding, anastomotic leakage, anastomotic obstruction, stenosis, intestinal leakage, intestinal obstruction, and other complications after the operation in the 30 patients. Conclusions Method of jejunum nutrition tube implantation in total laparoscopic radical gastrectomy for distal GC is easy to be performed. Intraoperative and postoperative complications are few. It provides a favorable guarantee for improving postoperative nutritional status of patient with distal GC.

Citation： DING Tianlong, LIU Xiaolong, WANG Dan, MA Yanling, LI Xuemei, GU Baohong, CHEN Yajing, CUI Hongbin, DANG Jianzhong, CHEN Hao. Experience of jejunum nutrition tube implantation in total laparoscopic radical gastrectomy for distal gastric cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2018, 25(12): 1445-1448. doi: 10.7507/1007-9424.201807006 Copy

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2.	Gheorghe C, Pascu O, Iacob R, et al. Nutritional risk screening and prevalence of malnutrition on admission to gastroenterology departments: a multicentric study. Chirurgia (Bucur), 2013, 108(4): 535-541.
3.	Jie B, Jiang ZM, Nolan MT, et al. Impact of nutritional support on clinical outcome in patients at nutritional risk: a multicenter, prospective cohort study in Baltimore and Beijing teaching hospitals. Nutrition, 2010, 26(11-12): 1088-1093.
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5.	Harvey SE, Parrott F, Harrison DA, et al. Trial of the route of early nutritional support in critically ill adults. N Engl J Med, 2014, 371(18): 1673-1684.
6.	周文星, 白劍鋒. 術后不同營養支持方式的療效對比及臨床價值探討. 南京醫科大學學報 (自然科學版), 2014, 34(12): 1695-1696, 1710.
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8.	Zeng H, Zheng R, Guo Y, et al. Cancer survival in China, 2003-2005: a population-based study. Int J Cancer, 2015, 136(8): 1921-1930.
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12.	蔣奕, 吳國豪, 韓寓嵩, 等. 長期腸外營養的合理應用與并發癥防治. 中華外科雜志, 2014, 52(9): 709-713.
13.	劉洪一, 王白石, 張加金, 等. 早期腸內營養與腸外營養在胃癌根治術后應用效果比較. 中國腫瘤臨床, 2014, 41(18): 1166-1169.
14.	McClave SA, Martindale RG, Vanek VW, et al. Guidelines for the provision and assessment of nutrition support therapy in the adult critically ill patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.). JPEN J Parenter Enteral Nutr, 2009, 33(3): 277-316.
15.	黎介壽. 首選腸內營養的合理性. 腸外與腸內營養, 2013, 20(6): 321-323.
16.	劉勝, 臧衛東, 何皓, 等. 腹腔鏡胃癌全胃根治術后空腸造口早期腸內營養的臨床應用分析. 福建醫藥雜志, 2016, 38(6): 20-23.
17.	何彥坤, 張靜, 何若沖. 腸內與腸外營養對胃癌根治手術后患者恢復情況的 Meta 分析. 中華臨床醫師雜志 (電子版), 2013, 7(5): 2077-2081.
18.	閆炎, 吳齊. 上消化道腫瘤病人圍手術期內鏡輔助置入鼻空腸營養管的不同方法比較. 腸外與腸內營養, 2014, 21(4): 241-243, 246.
19.	張先進, 陳偉燾. 腸內營養常用置管方法的評價. 腸外與腸內營養, 2013, 20(4): 241-244.
20.	姚運河, 張春蓮, 劉士會, 等. 胃鏡下放置鼻胃管和空腸營養管建立腸內營養途徑的方法. 安徽醫藥, 2007, 11(10): 924-925.
21.	肖碩萌, 何雨, 伍曉汀, 等. 術中置入胃管及鼻空腸營養管的方法及體會. 中國普外基礎與臨床雜志, 2012, 19(1): 76.
22.	李冰, 李鵬, 鞏方明, 等. 鼻空腸管和空腸造瘺管置入術的療效對比. 中國腫瘤臨床, 2014, 41(18): 1163-1165.
23.	方錦革. 胃癌根治術后行空腸造口與其他營養支持方式的安全性和有效性的對比研究. 中國醫師雜志, 2014, 16(3): 350-352.
24.	Yu Z, Zhuang CL, Ye XZ, et al. Fast-track surgery in gastrectomy for gastric cancer: a systematic review and meta-analysis. Langenbecks Arch Surg, 2014, 399(1): 85-92.
25.	Marano L, Porfidia R, Pezzella M, et al. Clinical and immunological impact of early postoperative enteral immunonutrition after total gastrectomy in gastric cancer patients: a prospective randomized study. Ann Surg Oncol, 2013, 20(12): 3912-3918.
26.	馮立, 王峰, 董培德, 等. 胃癌患者根治術后早期腸內營養的臨床療效觀察. 中國普外基礎與臨床雜志, 2014, 21(3): 325-329.

1. Norouzy A, Hashemi P, Amiri A, et al. Adult malnutrition screening, prevalence in four Iranian hospitals: cross-sectional study. Mediterr J Nutr Metab, 2012, 5(1): 45-48.
2. Gheorghe C, Pascu O, Iacob R, et al. Nutritional risk screening and prevalence of malnutrition on admission to gastroenterology departments: a multicentric study. Chirurgia (Bucur), 2013, 108(4): 535-541.
3. Jie B, Jiang ZM, Nolan MT, et al. Impact of nutritional support on clinical outcome in patients at nutritional risk: a multicenter, prospective cohort study in Baltimore and Beijing teaching hospitals. Nutrition, 2010, 26(11-12): 1088-1093.
4. Leandro-Merhi VA, de Aquino JL, Sales Chagas JF. Nutrition status and risk factors associated with length of hospital stay for surgical patients. JPEN J Parenter Enteral Nutr, 2011, 35(2): 241-248.
5. Harvey SE, Parrott F, Harrison DA, et al. Trial of the route of early nutritional support in critically ill adults. N Engl J Med, 2014, 371(18): 1673-1684.
6. 周文星, 白劍鋒. 術后不同營養支持方式的療效對比及臨床價值探討. 南京醫科大學學報 (自然科學版), 2014, 34(12): 1695-1696, 1710.
7. 黎介壽. 胃腸手術的" 圍手術期營養處理”. 腸外與腸內營養, 2013, 20(2): 65-67.
8. Zeng H, Zheng R, Guo Y, et al. Cancer survival in China, 2003-2005: a population-based study. Int J Cancer, 2015, 136(8): 1921-1930.
9. 陳萬青, 鄭榮壽, 張思維, 等. 2013 年中國惡性腫瘤發病和死亡分析. 中國腫瘤, 2017, 26(1): 1-7.
10. Mauskopf JA, Candrilli SD, Chevrou-Séverac H, et al. Immunonutrition for patients undergoing elective surgery for gastrointestinal cancer: impact on hospital costs. World J Surg Oncol, 2012, 10: 136.
11. 王然, 陳志康, 文俏程, 等. 胃癌術后早期腸內營養的應用. 中國普通外科雜志, 2015, 24(9): 1345-1348.
12. 蔣奕, 吳國豪, 韓寓嵩, 等. 長期腸外營養的合理應用與并發癥防治. 中華外科雜志, 2014, 52(9): 709-713.
13. 劉洪一, 王白石, 張加金, 等. 早期腸內營養與腸外營養在胃癌根治術后應用效果比較. 中國腫瘤臨床, 2014, 41(18): 1166-1169.
14. McClave SA, Martindale RG, Vanek VW, et al. Guidelines for the provision and assessment of nutrition support therapy in the adult critically ill patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.). JPEN J Parenter Enteral Nutr, 2009, 33(3): 277-316.
15. 黎介壽. 首選腸內營養的合理性. 腸外與腸內營養, 2013, 20(6): 321-323.
16. 劉勝, 臧衛東, 何皓, 等. 腹腔鏡胃癌全胃根治術后空腸造口早期腸內營養的臨床應用分析. 福建醫藥雜志, 2016, 38(6): 20-23.
17. 何彥坤, 張靜, 何若沖. 腸內與腸外營養對胃癌根治手術后患者恢復情況的 Meta 分析. 中華臨床醫師雜志 (電子版), 2013, 7(5): 2077-2081.
18. 閆炎, 吳齊. 上消化道腫瘤病人圍手術期內鏡輔助置入鼻空腸營養管的不同方法比較. 腸外與腸內營養, 2014, 21(4): 241-243, 246.
19. 張先進, 陳偉燾. 腸內營養常用置管方法的評價. 腸外與腸內營養, 2013, 20(4): 241-244.
20. 姚運河, 張春蓮, 劉士會, 等. 胃鏡下放置鼻胃管和空腸營養管建立腸內營養途徑的方法. 安徽醫藥, 2007, 11(10): 924-925.
21. 肖碩萌, 何雨, 伍曉汀, 等. 術中置入胃管及鼻空腸營養管的方法及體會. 中國普外基礎與臨床雜志, 2012, 19(1): 76.
22. 李冰, 李鵬, 鞏方明, 等. 鼻空腸管和空腸造瘺管置入術的療效對比. 中國腫瘤臨床, 2014, 41(18): 1163-1165.
23. 方錦革. 胃癌根治術后行空腸造口與其他營養支持方式的安全性和有效性的對比研究. 中國醫師雜志, 2014, 16(3): 350-352.
24. Yu Z, Zhuang CL, Ye XZ, et al. Fast-track surgery in gastrectomy for gastric cancer: a systematic review and meta-analysis. Langenbecks Arch Surg, 2014, 399(1): 85-92.
25. Marano L, Porfidia R, Pezzella M, et al. Clinical and immunological impact of early postoperative enteral immunonutrition after total gastrectomy in gastric cancer patients: a prospective randomized study. Ann Surg Oncol, 2013, 20(12): 3912-3918.
26. 馮立, 王峰, 董培德, 等. 胃癌患者根治術后早期腸內營養的臨床療效觀察. 中國普外基礎與臨床雜志, 2014, 21(3): 325-329.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Experience of jejunum nutrition tube implantation in total laparoscopic radical gastrectomy for distal gastric cancer

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