腹腔镜辅助远端胃癌根治术改良Uncut Roux-en-Y吻合对患者预后的影响  

Influence of laparoscopic assisted radical resection of distal gastric cancer on the prognosis of patients with improved Uncut Roux-en-Y anastomosis

作　　者：廖国庆[1] 何茂梁[1] 随凯[1] 张骏[1] 袁波[1] 何利[1] 曾昊[1] 程思俊 欧梦川 王思迅[2] 卢建利 Liao Guoqing;He Maoliang;Sui Kai;Zhang Jun;Yuan Bo;He Li;Zeng Hao;Cheng Sijun;Ou Mengchuan;Wang Sixun;Lu Jianli(Chengdu Sixth People’s Hospital Gastric surgery Chengdu,sichuan province 610051,China;Chengdu Sixth People’s Hospital Department of Neurology Chengdu,sichuan province 610051,China;Department of Hepatobiliary and pancreatic Surgery,363 Hospital Chengdu,sichuan province 610041,China)

机构地区：[1]成都市第六人民医院胃肠外科,成都610051 [2]成都市第六人民医院神经内科,成都610051 [3]三六三医院肝胆胰外科,成都610041

出　　处：《中华普外科手术学杂志（电子版）》2021年第4期411-414,共4页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

基　　金：四川省卫生和计划生育委员会科研课题(17PJ093);2019年四川省医学(青年创新)科研课题(Q19051)。

摘　　要：目的探讨腹腔镜辅助远端胃癌根治术Uncut Roux-en-Y(U-RY)吻合与改良U-RY吻合的临床效果。方法回顾性分析2017年1月至2019年6月接受腹腔镜辅助远端胃癌根治术治疗的92例患者资料,按照不同吻合术式分为两组,其中44例行U-RY吻合为U-RY组;48例行改良U-RY吻合为改良组。采用统计软件SPSS 21.00进行数据分析,围术期各项指标等计量资料采用(x±s)表示,独立t检验;并发症发生情况比较采用χ^(2)检验;P<0.05为有差异统计学意义。结果改良组手术时间、首次通气和住院时间少于U-RY组(P<0.05);改良组术后并发症总发生率14.6%(7/48)小于U-RY组29.5%(13/44);术后随访1年,U-RY组患者共发生闭合点再通发生率9.1%,改良组暂无闭合点再通发生(0%),两组比较差异均无统计学意义(P>0.05)。结论腹腔镜辅助远端胃癌根治术中应用改良U-RY吻合安全可行,较传统U-RY吻合术吻合,术后恢复快,可一定程度降低闭合口再通的发生率,可在临床推广使用。Objective To investigate the clinical effect of laparoscopic assisted radical gastrectomy for distal gastric cancer with Uncut Roux-EN-Y anastomosis and modified Uncut Roux-en-Y anastomosis.Methods The data of 92 patients who received laparoscopic-assisted radical resection of distal gastric cancer from January 2017 to June 2019 were retrospectively analyzed.According to different anastomosis procedures,the patients were divided into two groups,among which 44 cases of Uncut roux-en-y anastomosis were classified as U-ry group.Forty-eight cases of modified Uncut roux-en-y anastomosis were divided into the improved group.Statistical software SPSS 21.00 was used for data analysis.Perioperative indicators such as measurement data using (x±s) said,independent t test;The incidence of complications was compared byχ^(2) test.P<0.05 was considered statistically significant.Results The duration of operation,first ventilation and hospital stay in the modified group were less than those in the U-RY group(P<0.05).The total incidence of postoperative complications in the improved group was 14.6%(7/48)less than that in the U-RY group,29.5%(13/44).After 1 year of postoperative follow-up,9.1%of patients in the U-RY group had closed point recanalization,while no closed point recanalization occurred in the improved group(0%),and there was no statistically significant difference between the two groups(P>0.05).ConclusionLaparoscopic assisted radical resection of distal gastric cancer with improved Uncut Roux-en-Y anastomosis is safe and feasible.Compared with traditional U-RY anastomosis,the anastomosis results in faster postoperative recovery,which can reduce the incidence of closed mouth recanalization to a certain extent,and can be popularized in clinical use.

关 键 词：胃肿瘤 腹腔镜 远端胃癌根治术 吻合术 Roux-en-Y 疗效比较研究 

分 类 号：R73[医药卫生—肿瘤]