腹腔镜辅助近端胃切除双通道吻合技术治疗SiewertⅡ型食管胃结合部腺癌的近期疗效分析  

Analysis of short-term efficacy of laparoscope-assisted proximal gastrectomy double-channel anastomosis for Siewert typeⅡesophagogastric conjunctive adenocarcinoma

作　　者：韩超[1] 解曙哲[1] 赵强[1] 宋应明[1] 连长红[1] Han Chao;Xie Shuzhe;Zhao Qiang;Song Yingming;Lian Changhong(Department of Gastrointestinal Surgery,Heping Hospital Affiliated to Changzhi Medical Colleage,Changzhi Shanxi Province 046000,China)

机构地区：[1]长治医学院附属和平医院胃肠外科,山西长治046000

出　　处：《中华普外科手术学杂志（电子版）》2023年第3期296-299,共4页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

基　　金：山西省自然科学基金资助项目(202103021224006)。

摘　　要：目的探讨腹腔镜辅助近端胃切除双通道吻合技术在SiewertⅡ型食管胃结合部腺癌的中的安全性及近期疗效。方法回顾性分析2021年1月至2022年1月28例SiewertⅡ型食管胃结合部腺癌患者的临床资料,其中男性20例,女性8例。采用SPSS 21.0统计学软件进行统计学分析。围手术期指标、胃食管反流病(GERD)量表分析等计量资料以(x^(-)±s)表示,采用配对t检验对手术前后的GERD评分作比较。术后并发症分级计数资料采用[例(%)]表示。P<0.05为差异具有统计学意义。结果28例患者均完成腹腔镜辅助近端胃切除双通道吻合术。手术时间(3.5±0.6)h,术中出血量(100.2±10.6)ml,术后住院时间(12.8±2.7)d。所有患者术后均无吻合口狭窄发生,均未发生吻合口出血、腹腔感染及死亡。术后出现反流症状2例(7.1%),为Clavien-DindoⅠ级,胃镜检查可见其有反流性食管炎征象,洛杉矶分级为A级。术后3个月,食管胃反流测量表GERD评分为(2.8±0.7)分,与术前(2.3±0.5)分相比,差异无统计学意义(t=-1.553,P=0.133)。结论腹腔镜辅助近端胃切除双通道吻合手术安全可行,不会增加术后并发症及反流性食管炎的发生风险。Objective To investigate the safety and short-term efficacy of laparoscopically assisted proximal gastrectomy double-channel anastomosis in Siewert typeⅡesophageal and gastric conjunctive adenocarcinoma.Methods Clinical data of 28 patients with Siewert typeⅡadenocarcinoma of esophagogastric junction between January 2021 and January 2022 were retrospectively analyzed,including 20 males and 8 females.SPSS 21.0 statistical software was used for statistical analysis.Perioperative indicators,gastroesophageal reflux disease(GERD)scale analysis and other measurement data were expressed as(x^(-)±s).Paired t test was used to compare GERD scores before and after surgery.The grading data of postoperative complications were expressed as[n(%)].P<0.05 was considered statistically significant.Results All the 28 patients underwent laparoscopic assisted proximal gastrectomy with double channel anastomosis.The operation time was(3.5±0.6)h,the intraoperative blood loss was(100.2±10.6)ml,and the postoperative hospital stay was(12.8±2.7)d.No postoperative anastomotic stenosis occurred in all patients.No postoperative anastomotic hemorrhage,abdominal infection or death occurred in all patients.Postoperative reflux symptoms occurred in 2 cases(7.1%),which were Clavien-Dindo gradeⅠ.Gastroscopy showed signs of reflux esophagitis,and the Los Angeles grade was A.Three months after surgery,the GERD score of the esophagogastric reflux scale was(2.8±0.7)points,which had no statistical significance compared with that before surgery(2.3±0.5)points(t=-1.553,P=0.133).Conclusion Laparoscopic assisted proximal gastrectomy with double-channel anastomosis is safe and feasible without increasing the risk of postoperative complications and reflux esophagitis.

关 键 词：食管胃结合部腺癌 胃切除术 消化道重建 双通道吻合 

分 类 号：R735.2[医药卫生—肿瘤]