技术：腹腔镜远端胃癌根治术（图文演示）

20. 结论
• 处置
术后管理和后续类似于传统方法。
引流管的使用仍有争论，依照医师的喜好而定。
在触觉控制下，于吻合处放置经鼻胃管。在移除前，以低速吸入(小于30 mm Hg)维持2 到5天 。
以食道吞咽x光摄影 (Gastrograffin swallow) 检测吻合处之后恢复进食。

• 迷走神经切断术
当胃窦切除术(antrectomy)的适应症是酸依赖型溃疡疾病的时候，可以加入迷走神经切除术。

• 后方迷走神经切断术


• 前方迷走神经切断术


• 好处
腹腔镜方式进行胃切除术的好处在于可以有完整的腹腔曝露，且对有完善训练的手术团队而言，效果和开腹手术一样。文献的早期发现并没有和此方式相关的特定并发症。虽然手术时间可能比较长，但是病患的术后舒适度有改善。影像辅助手术之后的肠道功能恢复、进食量、表现指数、病患满意度都比传统手术好。
完全通过内镜进行吻合似乎并没有提供明显的优势。可以通过用来摘取样本的切口安全地进行吻合术。

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