SPLT联合间置空肠双通道吻合在腹腔镜近端胃切除术中的近期疗效和生活质量研究  

Short-term efficacy and quality of life of SPLT combined with interposition jejunal double channel anastomosis in laparoscopic proximal gastrectomy

作　　者：潘玉霞 魏曼莉 魏金鑫 董云生 Pan Yuxia;Wei Manli;Wei Jinxin;Dong Yunsheng(Department of Gastroenterology and Intestinal Surgery;The Fourth Affiliated Hospital of Nanjing Medical University,Fourth Afiliaed Hospital of Nanjing Medical University,Nanjing Jiangsu Prorince 210031,China)

机构地区：[1]南京医科大学第四附属医院胃肠外科,南京210031 [2]南京医科大学第四附属医院院办,南京210031

出　　处：《中华普外科手术学杂志（电子版）》2023年第4期380-384,共5页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

基　　金：江苏省老龄恶性肿瘤患者生活质量体系提升创新研究(2ISSL055)。

摘　　要：目的对比分析腹腔镜近端胃切除术(LPG)两种抗反流消化道重建术式的近期疗效和患者术后生活质量。方法回顾性分析2020年1月至2022年1月102例胃癌行LPG患者的临床资料,根据抗反流消化道重建术式不同将患者分为双通道组(n=57)和联合组(n=45)。双通道组采用间置空肠双通道吻合术,联合组采用自牵引后离断(SPLT)技术联合间置空肠双通道吻合。数据应用软件SPSS 22.0处理,围手术期相关指标、患者生活质量评分等计量资料采用(x±s)表示,行独立样本1检验;术后并发症情况等计数资料采用[例(%)]表示,行χ^(2)检验。P<0.05为差异有统计学意义。结果联合组患者手术时间及消化道重建时间较双通道组显著降低,淋巴结清扫数目显著增多(P<0.05)。联合组患者术后并发症总发生率显著低于双通道组(11.1%us.28.1%,P<0.05)。癌症生命质量核心量表(QLQ-C30)评分结果显示,联合组患者总体健康状况及功能状况评分均显著高于双通道组(P<0.05),症状情况评分显著低于双通道组(P<0.05);胃癌补充量表(QLQ-ST022)评分结果显示,联合组患者在疼痛、反流症状、进食受限及焦虑方面的评分均显著低于双通道组(P<0.05)。结论LPG中两种抗反流消化道重建方式均是安全可行的。而SPLT联合间置空肠双通道吻合可提供更大且清晰的手术视野,简化了手术操作,提高了淋巴结清扫的彻底性,降低了术后并发症的发生,并改善了患者术后生活质量,值得临床推广。Objective To compare the short-term efficacy and quality of life of laparoscopic proximal gastrectomy(LPG)for anti-reflux digestive tract reconstruction.Methods Clinical data of 102 patients with LPG gastric cancer admitted to our hospital from January 2020 to January 2022 were retrospectively analyzed,and the patients were divided into dual channel group(n=57)and combined group(n=45)according to different anti-reflux digestive tract reconstruction methods.Double-channel jejunal anastomosis was performed in the double-channel group,and SPLT was performed in the combined group.The data were processed by SPSS 22.O software.Perioperative indicators,quality of life scores and other measurement data were expressed by(x±s),and independent t test was performed.Statistical data such as postoperative complications were represented by[n(%)]and χ^(2) test was performed.P<0.05 was considered statistically significant.Results The operation time and digestive tract reconstruction time in combined group were significantly reduced compared with those in double-channel group,and the number of lymph node dissection was significantly increased(P<0.05).The overal incidence of postoperative complications in the combined group was significantly lower than that in the dual-channel group(11.1%vs.28.1%,P<0.05).The results of Cancer Quality of Life Core Scale(QLQ-C30)showed that the overall health status and functional status scores of the combined group were significantly higher than those of the dual-channel group(P<0.05),and the symptom scores were significantly lower than those of the dual-channel group(P<0.05).The results of the Gastric Cancer Supplement Scale(QLQ-STO22)showed that the scores of pain,reflux symptoms,food restriction and anxiety in the combined group were significantly lower than those in the dual-channel group(P<0.05).Conclusion The two anti-reflux digestive tract reconstruction methods in LPG are safe and feasible.SPLT combined with interposition jejunum double channel anastomosis can provide a larger and clearer

关 键 词：胃肿瘤 腹腔镜 胃切除术 消化道重建 双通道 

分 类 号：R735.2[医药卫生—肿瘤]