胃后壁吻合和胃大弯侧残角吻合在腹腔镜远端胃癌根治术Roux-en-Y重建中的对比研究  

Comparative study of posterior gastric wall anastomosis and greater curvature residual Angle anastomosis in Roux-en-Y reconstruction of distal gastric cancer after laparoscopic radical gastrectomy

作　　者：梁昌隆 林方德 蔡用军 陈化磊[3] Liang Changlong;Lin Fangde;Cai Yongjun;Chen Hualei(Department of General and Tunor Surgery,Wenchang People's Hopital,Wenchang Hainan Province 571300,China;Department of General Surgery,Wenchang People's Hopital,Wenchang Hainan Province 571300,China;The First filiated Hospital of Hainan Medical College,Haikou Hainan Prouince 570102,China)

机构地区：[1]文昌市人民医院普通、肿瘤外科,海南文昌571300 [2]文昌市人民医院普外科,海南文昌571300 [3]海南医学院第一附属医院,海口570102

出　　处：《中华普外科手术学杂志（电子版）》2022年第6期655-658,共4页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

基　　金：海南省卫生计生行业科研项目(18A200112)。

摘　　要：目的:研究Roux-en-Y消化道重建中两种不同胃肠吻合方式在腹腔镜远端胃癌根治术中的应用效果。方法:回顾性分析2018年6月至2020年7月157例行腹腔镜远端胃癌根治术并采取Roux-en-Y消化道重建的胃癌患者临床病例资料,根据胃肠吻合位置不同将其分为观察组(n=61例,行胃后壁吻合)和对照组(n=96例,行胃大弯侧残角吻合)。采用软件SPSS 20.0进行数据分析,两组患者围手术期指标、营养学指标及营养指数等计量资料用(x±s)表示,采用独立样本t检验;两组患者近远期并发症等计数资料用例数(百分比)表示,采用χ^(2)检验。P<0.05为差异有统计学意义。结果:两组患者围手术期相关指标差异无统计学意义(P>0.05)。观察组患者术后6个月血清白蛋白(ALB)水平及营养指数(PNI)优于对照组(P<0.05)。两组患者术后吻合口相关并发症、残胃炎、反流性食管炎、胆汁反流、Roux潴留综合征(RSS)、残胃再发癌等发生率差异均未见统计学意义(P>0.05);观察组患者胃瘫发生率低于对照组,胃瘫严重程度分级优于对照组(P<0.05)。结论:腹腔镜远端胃癌根治术Roux-en-Y消化道重建时行胃后壁吻合在减少胃瘫发生率,减轻胃瘫严重程度及维持术后营养状态方面具有优势;两种胃肠吻合方式在手术效果及抗碱性反流等方面差异无统计学意义。Objective To investigate the applieation effect of two dfferent gastrointestinal anastomosis methods in Roux-en-Y gastrointestinal reconstruction in laparoscopie radical gastrectomy for distal gastrie eancer.Methods The elinieal data of 157 patients with gastrie cancer who underwent laparoscopie radieal gastrectomy and Roux-en-Y digestive tract reconstruetion from June 2018 to July 2020 were retrospectively analyzed.Aecording to the location of gastrointestinal anastomosis,the patients were divided into observation group(n=61 ases,who underwent gastrie posterior wall anastomosis)and control group(n=96 cases,who underwent greater curvature esidual Angle anastomosis).SPSS 20.0 software was used for data analysis.The perioperative indicators,rutritional indicators and nutritinal index of the two groups were expressed as(x±s),and independent sample t lest was used.The short-term and long-term complications and other counting data of the two groups were expressed as the number of cases(percentage),and the χ^(2) test was used.P<0.05 was considered stistically significant.Results There was no significant difrence in perioperative indexes between the two groups(P>0.05).The serum albumin(ALB)level and nutritional index(PNI)of the obscrvation group were better than those of the control group at 6 monts after operation(P<0.05).There was no significant diference in the incidences of anastomose-related complieations,rsidual gastritis,relux esophagitis,bile relux,RSS syndrome and reurret ceancer of residual stomach between the two groups(P>0.05).The incidence of gastroparesis in the observation group was lower than that in the control group.and the severity grade ol gastroparesis was better than that in the control group(P<0.05).Conclusion Gastrie posterior wall anastomosis during Roux-en-Y gastrointestinal reconstruction in laparoscopie distal radical gastrectony has advantages in reducing the incidence of gastroparesis,reducing the severity of gastroparesis and maintaining postoperative nutritional status.There was no sign

关 键 词：胃肿瘤 腹腔镜 胃切除术 吻合术 Roux-en-Y 胃肠吻合术 

分 类 号：R735.2[医药卫生—肿瘤]