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.
ObjectiveTo recognize the recent research progress in the prevention of duodenal stump leakage (DSL) after laparoscopic radical gastrectomy (LRG) for gastric cancer, so as to find a new breakthrough point for reducing the occurrence of DSL. MethodA review was conducted by searching recent domestic and international literature on the prevention and management of DSL after LRG for gastric cancer. ResultsAt present, the risk factors of DSL after LRG were generally recognized in the literature, including patients’ relevant factors and surgery relevant factors. The relevant factors of the patients themselves mainly were old age, malnutrition, and basic diseases; The factors relevant surgery mainly included surgical instruments, doctors’ operation level, etc. According to the literature, the measures taken for patients’relevant factors mainly included preoperative improvement of nutritional status and control of the basic diseases; The preventive measures adopted for the operation relevant factors mainly included carefully intraoperative operation, improving the anastomosis skills, and tacit cooperation of the team, which could reduce the occurrence of DSL. There was still controversy about the effect and method of routine duodenal stump reinforcement during operation. ConclusionsThe focus of reducing the occurrence of DSL is prevention. In clinical practice, patients with high-risk factors should receive special attention, with efforts to improve their condition, implement individualized decision-making, and perform meticulous intraoperative techniques to minimize complications, promote rapid postoperative recovery, and maximize patient benefits.