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作 者:李松岩[1,2] 宋林杰 邢晓伟 吴世鹏[1] 胡子龙 张红亮[1] 杜晓辉[1]
机构地区:[1]解放军总医院普通外科,北京100853 [2]辽宁省盘锦市中心医院
出 处:《腹部外科》2017年第4期270-272,277,共4页Journal of Abdominal Surgery
基 金:国家自然科学基金(61170123)
摘 要:目的比较全腹腔镜远端胃癌D2根治三角吻合术与腹腔镜辅助远端胃癌D2根治BillrothⅠ吻合术的临床疗效。方法回顾性分析2014年2月至2016年2月间解放军总医院普通外科行远端胃癌D2根治临床病人135例的临床资料。观察组65例,行全腹腔镜远端胃癌D2根治三角吻合术;对照组70例,行腹腔镜辅助远端胃癌D2根治BillrothⅠ吻合术。结果两组病人性别及年龄等基本资料差异无统计学意义。观察组手术时间243.5 min,对照组180.2 min(P=0.005);观察组进食流质食物时间为(52.4±7.5)h,对照组为(45.8±5.3)h(P=0.042);观察组近端距离肿瘤为(48.2±7.5)mm,对照组为(40.4±5.6)mm(P=0.034);观察组远端距离肿瘤为(68.5±6.95)mm,对照组为(56.2±6.5)mm(P=0.028);观察组淋巴结清扫数为(34.8±8.4)个,对照组为(22.2±7.9)个(P=0.04);观察组手术出血量为(45.9±10.9)ml,对照组为(80.4±16.3)ml(P=0.018);观察组住院时间为(7.4±2.4)d,对照组为(10.4±1.7)d(P=0.016)。两组间术后并发症发生率差异无统计学意义。结论全腹腔镜下远端胃癌根治三角吻合技术具有创伤小、术后恢复快等优点,近期临床效果明显。Objective To compare the clinical efficacy of Delta-shaped anastomosis and BillrothⅠ anastomosis of laparoscopic distal gastrectomy for gastric cancer.Methods The clinical data of 135 cases of gastric cancer which received laparoscopic distal gastrectomy from Feb.2014 to Feb.2016 were reviewed.Observation group(n=65)received Delta-shaped anastomosis and control group(n=70)received Billroth Ⅰ anastomosis.Results There was no significant difference in basic characteristics such as age and sex.The operation time in the observation group and control group was 243.5 min and180.2 min respectively(P=0.005);Time for taking liquid food in the observation group was 52.4±7.5 h,and 45.8±5.3 h in the control group(P=0.042);The proximal distance to tumor edge in the observation group was 48.2±7.5 mm,and 40.4±5.64 mm in the control group(P=0.034);The distal distance to tumor edge in the observation group was 68.5±6.95 mm,and 56.2±6.5 mm in the control group(P=0.028);The number of harvested lymph nodes in the observation group was 34.8±8.4,and 22.2±7.9 in the control group(P=0.04);The blood loss in the observation group was45.9±10.9 mL,and 80.4±16.3 mL in the control group(P=0.018);The hospital stay in the observation group was 7.4±2.4 d,and10.4±1.7 d in the control group(P=0.016).There was no significant difference in postoperative complications between two groups.Conclusions Delta-shaped anastomosis of laparoscopic distal gastrectomy is feasible and safe with minimal trauma,quick recovery and good short-term clinical efficacy.
关 键 词:三角吻合 BillrothⅠ吻合术 胃癌
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