非离断式Roux-en-Y吻合术在胃癌消化道重建手术中的临床应用  

Observation on the Effect of Non-dissected Roux-en-Y Anatomy in Digestive Tract Reconstruction of Gastric Cancer

作　　者：蔡晓东[1] 吴红月 张彦春 王永胜 徐群 CAI Xiaodong;WU Hongyue;ZHANG Yanchun(Yangzhou Friendship Hospital,Yangzhou,225001)

机构地区：[1]江苏省扬州友好医院,225001 [2]江苏省常州市金坛区人民医院,225000

出　　处：《实用癌症杂志》2021年第11期1837-1840,共4页The Practical Journal of Cancer

基　　金：常州市科技计划项目(编号:CZ2016214)。

摘　　要：目的探讨非离断式Roux-en-Y吻合术应用于临床胃癌消化道重建手术中的效果。方法选取90例胃癌患者,按照手术治疗方法不同分组为对照组与观察组,各45例。所有患者均行完全腹腔镜下胃癌全切术治疗,其中对照组行传统食管空肠Roux-en-Y吻合术,观察组行非离断式Roux-en-Y吻合术。记录2组患者平均手术时间、消化道重建时间、术中出血量、术后排气时间、进流质食物时间、术后住院时间;术后进行病理检查,统计2组淋巴结清扫数目。随访12个月,记录2组术后情况。结果观察组手术平均时间、消化道重建时间、术中平均出血量、术后排气时间、进流质时间、术后住院时间均明显短于对照组,差异均有统计学意义(P<0.05)。观察组淋巴结清扫数目平均为(34.85±11.26)枚,与对照组的(32.84±11.74)枚比较,t=0.829,P=0.409。随访发现,2组术后情况相比较,P>0.05。结论非离断式Roux-en-Y吻合术应用于胃癌消化道重建术中效果显著,有利于促进患者康复,且安全,值得推广。Objective To investigate the effect of non-dissected Roux-en-Y anastomosis in digestive tract reconstruction of gastric cancer.Methods 90 patients with gastric cancer diagnosed and treated were divided into the control group(n=45)and the observation group(n=45).All patients were treated with complete laparoscopic total resection of gastric cancer,the control group was treated with traditional esophageal-jejunal Roux-en-Y anastomosis,and the observation group was treated with non-dissected Roux-en-Y anastomosis.The average operation time,digestive tract reconstruction time,intraoperative blood loss,postoperative exhaust time,feed food time and postoperative hospital stay were recorded in the 2 groups.Pathological examination was performed after operation,and the number of lymph node dissection in the 2 groups was counted.The patients were followed up for 12 months and the postoperative conditions of the 2 groups were recorded.Results The average operation time,the digestive tract reconstruction time,the average intraoperative blood loss,and the postoperative exhaust time,the infusion time,and the postoperative hospital stay in the observation group were significantly shorter than those of the control group(P<0.05).The average number of lymph node dissection was(34.85±11.26)in the observation group and(32.84±11.74)in the control group(t=0.829,P=0.409).Follow-up showed that the postoperative conditions were compared between the 2 groups(P<0.05).Conclusion The application of non-dissected Roux-en-Y anastomosis in gastrointestinal reconstruction of gastric cancer is effective,is beneficial to promote the rehabilitation of patients,and has high safety,which is worth popularizing.

关 键 词：非离断式Roux-en-Y吻合术 胃癌 腹腔镜 全胃切除术 消化道重建术 

分 类 号：R735.2[医药卫生—肿瘤]