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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6.	周文星, 白剑锋. 术后不同营养支持方式的疗效对比及临床价值探讨. 南京医科大学学报 (自然科学版), 2014, 34(12): 1695-1696, 1710.
7.	黎介寿. 胃肠手术的" 围手术期营养处理”. 肠外与肠内营养, 2013, 20(2): 65-67.
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9.	陈万青, 郑荣寿, 张思维, 等. 2013 年中国恶性肿瘤发病和死亡分析. 中国肿瘤, 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, 陈志康, 文俏程, 等. 胃癌术后早期肠内营养的应用. 中国普通外科杂志, 2015, 24(9): 1345-1348.
12.	蒋奕, 吴国豪, 韩寓嵩, 等. 长期肠外营养的合理应用与并发症防治. 中华外科杂志, 2014, 52(9): 709-713.
13.	刘洪一, 王白石, 张加金, 等. 早期肠内营养与肠外营养在胃癌根治术后应用效果比较. 中国肿瘤临床, 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.	黎介寿. 首选肠内营养的合理性. 肠外与肠内营养, 2013, 20(6): 321-323.
16.	刘胜, 臧卫东, 何皓, 等. 腹腔镜胃癌全胃根治术后空肠造口早期肠内营养的临床应用分析. 福建医药杂志, 2016, 38(6): 20-23.
17.	何彦坤, 张静, 何若冲. 肠内与肠外营养对胃癌根治手术后患者恢复情况的 Meta 分析. 中华临床医师杂志 (电子版), 2013, 7(5): 2077-2081.
18.	闫炎, 吴齐. 上消化道肿瘤病人围手术期内镜辅助置入鼻空肠营养管的不同方法比较. 肠外与肠内营养, 2014, 21(4): 241-243, 246.
19.	张先进, 陈伟焘. 肠内营养常用置管方法的评价. 肠外与肠内营养, 2013, 20(4): 241-244.
20.	姚运河, 张春莲, 刘士会, 等. 胃镜下放置鼻胃管和空肠营养管建立肠内营养途径的方法. 安徽医药, 2007, 11(10): 924-925.
21.	肖硕萌, 何雨, 伍晓汀, 等. 术中置入胃管及鼻空肠营养管的方法及体会. 中国普外基础与临床杂志, 2012, 19(1): 76.
22.	李冰, 李鹏, 巩方明, 等. 鼻空肠管和空肠造瘘管置入术的疗效对比. 中国肿瘤临床, 2014, 41(18): 1163-1165.
23.	方锦革. 胃癌根治术后行空肠造口与其他营养支持方式的安全性和有效性的对比研究. 中国医师杂志, 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.	冯立, 王峰, 董培德, 等. 胃癌患者根治术后早期肠内营养的临床疗效观察. 中国普外基础与临床杂志, 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, 白剑锋. 术后不同营养支持方式的疗效对比及临床价值探讨. 南京医科大学学报 (自然科学版), 2014, 34(12): 1695-1696, 1710.
7. 黎介寿. 胃肠手术的" 围手术期营养处理”. 肠外与肠内营养, 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. 陈万青, 郑荣寿, 张思维, 等. 2013 年中国恶性肿瘤发病和死亡分析. 中国肿瘤, 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, 陈志康, 文俏程, 等. 胃癌术后早期肠内营养的应用. 中国普通外科杂志, 2015, 24(9): 1345-1348.
12. 蒋奕, 吴国豪, 韩寓嵩, 等. 长期肠外营养的合理应用与并发症防治. 中华外科杂志, 2014, 52(9): 709-713.
13. 刘洪一, 王白石, 张加金, 等. 早期肠内营养与肠外营养在胃癌根治术后应用效果比较. 中国肿瘤临床, 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. 黎介寿. 首选肠内营养的合理性. 肠外与肠内营养, 2013, 20(6): 321-323.
16. 刘胜, 臧卫东, 何皓, 等. 腹腔镜胃癌全胃根治术后空肠造口早期肠内营养的临床应用分析. 福建医药杂志, 2016, 38(6): 20-23.
17. 何彦坤, 张静, 何若冲. 肠内与肠外营养对胃癌根治手术后患者恢复情况的 Meta 分析. 中华临床医师杂志 (电子版), 2013, 7(5): 2077-2081.
18. 闫炎, 吴齐. 上消化道肿瘤病人围手术期内镜辅助置入鼻空肠营养管的不同方法比较. 肠外与肠内营养, 2014, 21(4): 241-243, 246.
19. 张先进, 陈伟焘. 肠内营养常用置管方法的评价. 肠外与肠内营养, 2013, 20(4): 241-244.
20. 姚运河, 张春莲, 刘士会, 等. 胃镜下放置鼻胃管和空肠营养管建立肠内营养途径的方法. 安徽医药, 2007, 11(10): 924-925.
21. 肖硕萌, 何雨, 伍晓汀, 等. 术中置入胃管及鼻空肠营养管的方法及体会. 中国普外基础与临床杂志, 2012, 19(1): 76.
22. 李冰, 李鹏, 巩方明, 等. 鼻空肠管和空肠造瘘管置入术的疗效对比. 中国肿瘤临床, 2014, 41(18): 1163-1165.
23. 方锦革. 胃癌根治术后行空肠造口与其他营养支持方式的安全性和有效性的对比研究. 中国医师杂志, 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. 冯立, 王峰, 董培德, 等. 胃癌患者根治术后早期肠内营养的临床疗效观察. 中国普外基础与临床杂志, 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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