uncut Roux-en-Y吻合在腹腔镜辅助下胃癌根治术中的临床应用  

Use of uncut Roux-en-Y reconstruction after laparoscopic-assisted gastrectomy for gastric carcinoma

作　　者：熊建波[1] 李正荣[1] 罗贤施 曹毅[1] 张国阳[1] 刘逸[1] 揭志刚[1] XIONG Jianbo;LI Zhengrong;LUO Xianshi;CAO Yi;ZHANG Guoyang;LIU Yi;JIE Zhigang(Department of Gastrointestinal Surgery,the First Affiliated Hospital of Nanchang University,Nanchang 330006,China)

机构地区：[1]南昌大学第一附属医院胃肠外科,南昌330006

出　　处：《实用医学杂志》2018年第19期3203-3206,共4页The Journal of Practical Medicine

基　　金：国家自然科学基金资助项目(编号:81460373;81360362);江西省教育厅科学技术研究基金资助项目(编号:GJJ13126;GJJ160246);江西省青年科学家培养计划基金资助项目(编号:20133BCB23028)

摘　　要：目的比较腹腔镜辅助下胃癌根治术后B-I式、B-II式、RY吻合、uncut Roux-en-Y(uncut RY)吻合的手术情况及术后并发症。方法回顾性分析南昌大学第一附属医院2014年1月至2016年5月行腹腔镜辅助下胃癌根治术的患者121例,根据不同的消化道重建方式分为:B-I式组35例,B-II式组29例,RY组25例,uncut RY组32例。全组患者术后随访6个月以上,比较其近期、远期并发症发生率。结果 uncutRY组在术后首次通气时间、术后恢复流质饮食时间较B-II式及RY组缩短,术后反流性胃炎、反流性食管炎发生率减少,Roux潴留综合征发生率较RY组下降。结论 uncut Roux-en-Y吻合术能明显改善患者生存质量,是腹腔镜辅助下胃癌根治术后理想的消化道重建方式。Objective To investigate the clinical efficacy of uncut Roux-en-Y reconstruction after laparo-scopic-assisted gastrectomy for gastric carcinoma.Methods A total of 121 patients who underwent laparoscopic-assisted gastrectomy for gastric carcinoma,from January 2014 to May 2016,in the first hospital affiliated to Nanchang University were recruited.Clinical data of these patients with complete follow-up data was collected.The patients were classified into four groups based on the reconstructive procedure:BI group(35 cases),BII group(29 cases),RY group(25 cases)and uncut RY group(32 cases).Results In uncut RY group,the exhausting time for the first time and the first liquid time after postoperative were shorter than those in BII and RY group.There were less alkaline reflex gastritis/reflux esophagitis rate and incidence of Roux-en-Y stasis rate than RY group.Conclusion The uncut Roux-en-Y has significance advantage in improving the living quality of patients.It may be the preferred technique for reconstruction after laparoscopic-assisted gastrectomy.

关 键 词：胃癌根治术 消化道重建 uncut ROUX-EN-Y 腹腔镜 Roux潴留综合征 

分 类 号：R735.2[医药卫生—肿瘤]