反式抵钉座法吻合方式在腹腔镜下行全胃切除术后的应用效果评价  

Clinical investigation of hemi-double stapling esophagojejunostomy in laparoscpic total gastrectomy

作　　者：王扬州[1] 杨金香[1] 蒋清华[1] 张秀芹[2] 

机构地区：[1]第二军医大学长征医院南京分院普外科,南京210000 [2]南京市妇幼保健院普儿科,2210004

出　　处：《中华普外科手术学杂志（电子版）》2015年第5期51-53,共3页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

摘　　要：目的探讨反式抵钉座法吻合方式在腹腔镜下行全胃切除术后的应用效果。方法将60例接受腹腔镜下行全胃切除术患者随机分为反式组和经口组,反式组患者(26例)采用反式抵钉座法吻合,经口组患者(34例)采用经口抵钉座法吻合。采用SPSS 20.0软件分析,术中资料和术后恢复情况等计量资料符合正态分布,采用(x珋±s)表示,组间比较t检验,术后并发症等计数资料采用χ2检验,P<0.05为差异具有统计学意义。结果反式组患者抵钉座置入时间为(13.7±6.3)min和术中出血量为(83.5±15.2)ml显著低于经口组的(17.5±7.1)min和(96.3±30.4)ml(t=2.191,2.131,P<0.05);术后并发症:反式组2例(7.7%)显著低于经口组的10例(29.4%)(χ2=4.344,P<0.05),差异均有统计学意义。淋巴结清扫数目、切口长度、术后排气时间、进食时间、首次下床活动时间和住院时间等指标差异无统计学意义(P>0.05)。结论反式抵钉座法吻合方式应用于腹腔镜下行全胃切除可以有效降低手术时间和术中出血量并减少不良反应的发生,具有临床应用价值。Objective To investigate the clinical outcome of hemi-double stapling esophagojejunostomy in laparoscpic total gastrectomy. Methods Sixty patients underwent laparoscpic total gastrcctomy were randomly divided into hemi-double group （ n = 26 ） and transoral group （ n = 34 ） . SPSS20.0 software was applied to analyze the clinical data. Operative data and post operation recovery data were normally distributed and were represented as mean ± SD and examined by Student＇ s t test. Count data including complication rate were examined by the Chi-square test, P 〈 0.05 was considered as statistically significant. Results The esophagojejunostomy time was （ 13. 7 ± 6. 3 ） minutes and blood loss was （83.5 ± 15.2） ml in the hemi-double group which significantly shorter than （ 17.5±7.1 ） minutes and （96.3 ± 30.4） ml in the transoral group （t = 2. 191, 2. 131 respectively, P 〈 0.05）. There were 2 complications in the hemi-double group [7.7% （2/26） ] which were significantly less than 10 in the transoral group [ 29.4% （10/34） ] （χ^2 = 4. 344, P 〈 0.05 ）. There was no significant difference in the number of harvested lymph node, length of incision, time of anal exhaust, time of food intake, time of out-of-bed activity, and length of stay between the two groups （ P 〉 0.05 ）. Conclusion Hemi-double stapling esophagojejunostomy in laparoscpic total gastreetomy could reduce operative time, blood loss, and complications; it is feasible for wide clinical application.

关 键 词：胃肿瘤 胃切除术 腹腔镜检查 外科缝合器缝合 

分 类 号：R735.2[医药卫生—肿瘤]