R-Y吻合在远端胃癌根治术中的应用  

The application of R-Y anastomosis in the radical operation of distal gastric cancer

作　　者：吕进[1] 王和明[1] 徐晓军[2] 王志 Lv Jin;Wang Heming;Xu Xiaojun;Wang Zhi(Department of General Surgery,Nanjing First Hospital,Nanjing Medical University,Jiangsu Nanjing 210006,China;Department of Gastroenterology,Nanjing First Hospital,Nanjing Medical University,Jiangsu Nanjing 210006,China)

机构地区：[1]南京医科大学附属南京医院(南京市第一医院)普外科,江苏南京210006 [2]南京医科大学附属南京医院(南京市第一医院)消化科,江苏南京210006

出　　处：《现代肿瘤医学》2019年第12期2134-2137,共4页Journal of Modern Oncology

摘　　要：目的:探讨R-Y吻合在远端胃癌根治术中的优势。方法:回顾性分析并总结我院近3年56例远端胃癌根治术患者临床资料,B-Ⅱ吻合术组26例,R-Y吻合术组30例。比较两组患者术后并发症及营养状态。结果:R-Y组手术时间略长于B-Ⅱ组(P<0.05); R-Y组反流性食管炎发生率低于B-Ⅱ组(P<0.05),其余并发症差异无统计学意义(P>0.05);两组住院天数相似无差异(P>0.05);两组患者术后1年BMI变化、白蛋白变化、淋巴细胞计数变化差异无统计学意义(P>0.05)。结论:R-Y术式在远端胃癌根治术消化道重建中是安全可靠的,反流性食管炎发生率降低,改善了患者术后生活质量,应作为远端胃癌根治术的首选吻合方式。Objective:To evaluate the advantages of R-Y anastomosis in the radical gastrectomy of distal gastric carcinoma.Methods:56 patients with radical gastrectomy of distal gastric cancer in our hospital were retrospectively analyzed,including 26 cases of B-Ⅱanastomosis group,and 30 cases of R-Y anastomosis group.Postoperative complications and nutritional status were compared between the two groups.Results:The operation time of R-Y group was slightly longer than that of B-Ⅱgroup(P<0.05).The incidence of reflux esophagitis in R-Y group was lower than that in B-Ⅱ group(P<0.05),and the remaining complications were not statistically significant(P>0.05).There was no difference in hospitalization day between the two groups(P>0.05).It was found that the change after 1 year in BMI,albumin and lymphocyte count were not statistically significant(P>0.05).Conclusion:R-Y is safe and reliable in the reconstruction of the digestive tract of distal gastric cancer.The incidence of reflux esophagitis is reduced,and the quality of postoperative life of patients is improved,which should be the preferred anastomosis of the radical gastrectomy for distal gastric cancer.

关 键 词：远端胃癌 ROUX-EN-Y Billroth-Ⅱ 消化道重建 

分 类 号：R735.2[医药卫生—肿瘤]