全腹腔镜及腹腔镜辅助远端胃癌毕Ⅰ式胃肠道重建的对比研究  

Comparative study of totally laparoscopic and laparoscopic assisted Billroth Ⅰ gastrointestinal reconstruction for distal gastric cancer

作　　者：王再兴[1] 蔡逊[1] 

机构地区：[1]广州军区武汉总医院,湖北武汉430070

出　　处：《腹腔镜外科杂志》2014年第11期818-821,共4页Journal of Laparoscopic Surgery

摘　　要：目的：探讨全腹腔镜毕Ⅰ式胃肠道重建（三角吻合）的可行性、安全性及临床疗效。方法：回顾分析2013年6月至2014年1月施行的41例腹腔镜远端胃癌根治术的临床资料,其中23例行全腹腔镜毕Ⅰ式胃肠道重建术（三角吻合,A组）,18例行腹腔镜辅助毕Ⅰ式胃肠道重建术（B组）,对比分析两组患者的手术疗效。结果：两组患者胃肠道重建时间[（24±12）min vs.（26±15）min]、术后首次进流食时间[（3.7±1.8）d vs.（3.9±2.1）d]、术后住院时间[（8.5±2.7）d vs.（8.7±2.9）d]差异无统计学意义。A组止痛药使用次数明显少于B组[（1.7±1.5）vs.（3.5±1.9）,P〈0.05]。术后随访3~10个月,均未发生吻合口狭窄、吻合口漏、吻合口出血等手术并发症。结论：全腹腔镜毕Ⅰ式胃肠道重建（三角吻合）是安全、可行的,近期疗效满意,远期疗效尚需进一步观察研究。Objective ： To investigate the feasibility, safety and clinical efficacy of performing a totally laparoscopic Delta-shaped anastomosis for distal gastric cancer. Methods：This was a retrospective analysis of 23 patients who underwent a totally laparoscopic Billroth Ⅰ gastrointestinal reconstruction （Delta-shaped anastomosis, group A） and 18 patients who underwent laparoscopic assisted Billroth Ⅰ gastrointestinal reconstruction （group B） for distal gastric cancer. Results：The duration of anastomosis, postoperative fluid diet and post-operative hospital stay were not significantly different between the two groups [ （24 ± 12） rain vs. （26 ± 15 ） rain, （3.7 ± 1.8） d vs. （3.9 ± 2.1 ） d, （8.5 ± 2.7） d vs, （8.7 ± 2.9） d ]. Analgesics using in group A was significantly less frequent than in group B [ （ 1.7 ± 1.5） vs. （3.5 ± 1.9）, P 〈 0.05 ]. There was no stenosis, leakage, bleeding or other anastomotic complications hap- pened during the follow-up of 3-10 months. Conclusions：Totally laparoseopic Delta-shaped anastomosis for distal gastric cancer is con- sidered to be a safe and feasible modality which provides a satisfactory short-term efficacy. However, the further studies are required for the long-term efficacy.

关 键 词：远端胃肿瘤 毕Ⅰ式胃肠道重建 三角吻合 腹腔镜检查 

分 类 号：R735.2[医药卫生—肿瘤]