改良食管残胃吻合术在近端胃切除术治疗食管胃结合部癌中预防反流的临床效果  

Clinical effect of modified esophagogastrostomy for prevention of reflux in the treatment of esophagogastric junction carcinoma by proximal gastrectomy

作　　者：欧雷 罗之谦 陈旺文 龙凯军[1] Ou Lei;Luo Zhiqian;Chen Wangwen;Long Kaijun(Department of Ward 2 of the Traurma Medical Center,the Firsi Affiliated Hospital of Hainan Medical College,Haikou Hainan Prouvnce 570102,China)

机构地区：[1]海南医学院第一附属医院创伤医学中心二病区,海口570102

出　　处：《中华普外科手术学杂志（电子版）》2022年第4期403-406,共4页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

基　　金：海南省卫生健康行业科研项目(20A200131)。

摘　　要：目的探讨改良食管残胃吻合术在近端胃切除术治疗食管胃结合部癌(AEC)中预防反流的临床效果。方法前瞻性纳入2020年4月至2021年3月行腹腔镜近端胃癌切除术治疗的60例AEG患者临床资料,采用随机数字表法分为半包埋组和双通道组,每组各30例,半包埋组行半包埋活瓣式吻合,双通道组行双通道吻合。采用SPSS 22.0软件进行临床数据分析,围手术期指标,胃食管反流诊断量表(CerdQ)评分等计量资料用(x±s)表示,采用独立样本t检验;术后并发症等计数资料采用χ^(2)检验。P<0.05为差异有统计学意义。结果60例患者均顺利完成手术。半包埋组患者手术时间术后首次排气时间均短于双通道组患者(P<0.05);半包埋组患者术后1个月内并发症总发生率低于双通道组患者(P<0.05);术后7d、14d半包埋组患者GerdQ评分低于双通道组患者(P<0.05)。结论近端胃切除术中采用半包埋活瓣式吻合治疗食管胃结合部癌,具有手术时间、短术后恢复快、并发症少、抗反流效果显著等优势,安全可行,可在临床推广。Objective To investigate the clinical effect of modified esophagogastrle stump anastomosis in the prevention of refux in the treatment of adenocarcinoma of the esophagogastric junction(AEG)by proximal gastrectomy.Methods The clinical data of 60 AEG patients who underwent laparoscopic proximal gastrie cancer resection from April 2020 to March 2021 were prospectively included.They were divided into two groups by randon method,with 30 patients in each group.The semi-embedding group received semi-embedding flap anastomosis,and the two-channel group received two-channel anastomosis.SPSS 22.0 software was used for clinical data analysis.Perioperative indicators,GerdQ score and other measurement data were expressed by(x±s).and independent 1 test was used.Postoperative complications were counted by χ^(2) test.P<0.05 was considered statistically signifcant.Results All 60 patients sucessfully completed the operation.The operation time and the first postoperative exhaust time of semi-embedding group were shorter than those of double-channel group(P<0.05).The total incidence of complications in semi-embedding group within 1 month after surgery was lower than that in the double-channel group(P<0.05).The GerdQ scores of patients of semi-embedding group were lower than those in dual-channel group at 7 and 14 days afer surgery(P<0.05).Conclusion The use of semi-embedded fap anastomosis in proximal gastrectony for the treatment of esophagogastric junction carcinoma has the advantages of short operation time,quick postoperative recovery,fewer complications and significant anti-reflux ffect,which is safe and feasible and can be promoted in clinical practice.

关 键 词：食管胃结合部癌 近端胃切除术 半包埋活瓣式吻合 双通道吻合 疗效比较研究 

分 类 号：R73[医药卫生—肿瘤]