腹腔镜远端胃癌根治术消化道重建中Billroth Ⅱ+Braun吻合与单纯Billroth Ⅱ吻合的疗效比较  

Comparison of the efficacy of Billroth Ⅱ+ Braun anastomosis and simple Billroth Ⅱ anastomosis in digestive tract reconstruction after laparoscopic distal gastric cancer radical resection

作　　者：王怀帅[1] 蔡志聪 林高枫 许国玺[1] 庄奕翔 李银林 林奇忆 叶再元[2] Wang Huaishuai;Cai Zhicong;Lin Gaofeng;Xu Guoxi;Zhuang Yixiang;Li Yinlin;Lin Qiyi;Ye Zaiyuan(Department of Gastroenterology and Hernia Surgery,Jinjiang Municipal Hospital,Jinjiang 362214,China;General Surgery,Department of Gastrointestinal and Pancreatic Surgery,Zhejiang Provincial People′s Hospital(Affiliated People′s Hospital,Hangzhou Medical College),Hangzhou 310014,China)

机构地区：[1]晋江市医院(上海市第六人民医院福建医院)胃肠/疝与腹壁外科,晋江362214 [2]浙江省人民医院(杭州医学院附属人民医院)普通外科胃肠胰外科,杭州310014

出　　处：《中国医师杂志》2023年第10期1464-1467,共5页Journal of Chinese Physician

基　　金：福建省卫生健康科技计划项目(2022QNA093)

摘　　要：目的对比腹腔镜远端胃癌根治术消化道重建中BillrothⅡ+Braun吻合与单纯BillrothⅡ吻合的临床疗效及患者术后生活质量。方法选择2019年1月至2022年1月在晋江市医院行腹腔镜远端胃癌根治术治疗的68例患者的临床资料进行回顾性分析,将行BillrothⅡ+Braun吻合方式进行消化道重建的40例患者纳入观察组,行单纯BillrothⅡ吻合方式进行消化道重建的28例患者纳入对照组。收集两组围手术期相关指标及术后1年相关指标,观察患者术后的安全性及疗效。结果两组患者手术时间、术中出血量、术后排气时间、拔胃管进流食时间、拔引流管时间、术后住院时间比较差异均无统计学意义(均P>0.05)。两组患者术后并发症发生情况及分级比较,差异均无统计学意义(P>0.05)。术后1年观察组食物潴留、残胃炎发生率均低于对照组(均P<0.05),而两组胆汁反流、反流性食管炎发生率差异无统计学意义(均P>0.05)。术后1年观察组患者总蛋白下降量和预后营养指数(PNI)低于对照组,差异有统计学意义(均P<0.05);术后1年观察组腹胀、反流症状发生率低于对照组,差异有统计学意义(均P<0.05)。结论在腹腔镜远端胃癌根治术中,以BillrothⅡ+Braun吻合方式进行消化道重建安全性高,可以改善患者术后生活质量。Objective To compare the clinical efficacy and quality of life of patients between BillrothⅡ+Braun anastomosis and simple BillrothⅡanastomosis in digestive tract reconstruction after laparoscopic distal gastric cancer radical resection.Methods A retrospective analysis was performed on clinical data of 68 patients who underwent laparoscopic distal gastric cancer radical resection in Jinjiang Municipal Hospital from January 2019 to January 2022.Forty patients who underwent BillrothⅡ+Braun anastomosis were included in the observation group,and 28 patients who underwent simple BillrothⅡanastomosis were included in the control group.Perioperative indicators and postoperative indicators one year after surgery were collected to observe the safety and efficacy of patients after surgery.Results There were no significant differences in operation time,intraoperative bleeding volume,postoperative exhaust time,time to remove gastric tube and drainage tube,and postoperative hospital stay between the two groups(all P>0.05).There were also no significant differences in postoperative complications between the two groups(P>0.05).One year after surgery,the incidence of food retention and residual gastritis in the observation group were lower than those in the control group(all P<0.05),while there were no significant differences in the incidence of bile reflux and reflux esophagitis between the two groups(all P>0.05).One year after surgery,nutritional evaluation showed that the total protein decline and prognostic nutritional index(PNI)in the observation group were lower than those in the control group,with significant differences(all P<0.05).The incidence of bloating and reflux symptoms in the observation group one year after surgery was lower than that in the control group,with significant differences(all P<0.05).Conclusions BillrothⅡ+Braun anastomosis is a safe method for digestive tract reconstruction after laparoscopic distal gastric cancer resection,which can improve patients′quality of life after surgery.

关 键 词：胃肿瘤 胃切除术 消化道重建 BillrothⅡ吻合术 Braun吻合 

分 类 号：R735.2[医药卫生—肿瘤]