Uncut Roux-en-Y吻合术在腹腔镜远端胃癌根治术中的应用价值  

Application Value of Uncut Roux-en-Y Anastomosis in Laparoscopic Gastrectomy for Gastric Cancer

作　　者：王韬 张峥嵘[1] 武健[1] Wang Tao;Zhang Zhengrong;Wu Jian(Department of Gastrointestinal Surgery,Yijishan Hospital,Wannan Medical College)

机构地区：[1]皖南医学院弋矶山医院胃肠外科,241000

出　　处：《长治医学院学报》2020年第5期339-343,共5页Journal of Changzhi Medical College

摘　　要：目的:比较分析Uncut Roux-en-Y吻合术与传统BillrothⅡ吻合术在腹腔镜远端胃癌根治性切除病人手术中的应用价值。方法:回顾性分析我院胃肠外科88例胃癌患者的临床资料,其中42例术中行Uncut Roux-en-Y(URY)吻合术式的为观察组,46例行传统BillrothⅡ(B-Ⅱ)吻合术的为对照组,统计分析2组患者在术中情况(手术时间、消化道重建时间、术中出血量、淋巴结清扫数目)、术后早期肠道功能恢复(术后首次排气时间、首次下床活动时间)、并发症(术后吻合口瘘、Roux-en综合征发生率、输入袢再通等)及术后半年内回访相关指标(胆汁反流、反流性胃炎等)的差异。结果:观察组的手术时间、淋巴结清扫数量与对照组比较差异无统计学意义;观察组消化道重建时间短于对照组[(30.24±10.65)vs(38.16±12.95)] min,观察组术中出血量少于对照组[(128.52±14.26)vs(160.97±12.53)] mL,差异有统计学意义(P<0.05);观察组术后首次排气时间[(2.73±0.54)vs(4.29±1.16)] d、术后首次下床活动时间[(3.50±1.35)vs(5.28±1.62)] d较对照组短,差异有统计学意义(P<0.05);对照组的近、远期并发症发生率高于观察组,随访发现对照组术后胆汁反流,胃炎发生率较观察组高,差异有统计学意义(P<0.05)。结论:Uncut Roux-en-Y吻合方式是一种安全可行的吻合方式,在术后患者肠道功能的早期恢复、降低术后并发症、改善患者术后生活质量方面较传统吻合方式更优。Objective: To compare and analyze the application value of Uncut Roux-en-Y(URY) anastomosis and traditional Billroth Ⅱ(B-Ⅱ) anastomosis in patients undergoing laparoscopic radical resection of distal gastric cancer. Methods: The clinical data of 88 patients with gastric cancer were retrospectively analyzed, 42 of which underwent URY anastomosis during the operation were in the observation group, and 46 underwent traditional B-Ⅱ anastomosis were in the control group. Intraoperative conditions(operation, gastrointestinal reconstruction time, intraoperative blood loss, number of lymph node dissections), early postoperative recovery of intestinal function(the first postoperative exhaust time, the first time to get out of bed), complications(Postoperative anastomotic leakage, Roux-en syndrome incidence, recanalization of infusion loops), and the difference in related indicators(bile reflux, reflux gastritis) within six months after surgery of the two groups of patients were statistically analyzed. Results: The operation time and the number of lymph node dissections in the observation group were not statistically different from those in the control group. The observation group’s digestive tract reconstruction time [(30.24±10.65) vs(38.16±12.95)] min was shorter than that of the control group, and the observation group had intraoperative bleeding The amount of [(128.52±14.26) vs(160.97±12.53)] mL was less than that of the control group, the difference was statistically significant(P<0.05);the first postoperative exhaust time in the observation group was [(2.73±0.54) vs(4.29±1.16))] d, the first time to get out of bed after operation [(3.50±1.35) vs(5.28±1.62)] d is shorter than the control group, the difference is statistically significant(P<0.05);the short-term and long-term complications of the control group The incidence was higher than that of the observation group. Follow-up found that the incidence of bile reflux and gastritis after the traditional anastomosis was higher than that of the URY anasto

关 键 词：远端胃癌根治术 Uncut Roux-en-Y 腹腔镜 消化道重建 BillrothⅡ 

分 类 号：R735.2[医药卫生—肿瘤]