两个“半荷包”缝合包埋法加固十二指肠残端在胃癌根治术中的应用  

Application of two“half pocket”suture embedding method to strengthen duodenal stump in radical gastrectomy

作　　者：夏添明 许震[2] 王云帅[2] 李朝辉[2] 韩保卫[2] Xia Tianming;Xu Zhen;Wang Yunshuai;Li Chaohui;Han Baowei(Xinxiang Medical University,Xinxiang Henan Province 453000,China;Department of Gastrointestinal Surgery,Luoyang Central Hospital,Luoyang Henan Province 471000,China)

机构地区：[1]新乡医学院,河南新乡453000 [2]洛阳市中心医院胃肠外科,河南洛阳471000

出　　处：《中华普外科手术学杂志（电子版）》2023年第4期389-392,共4页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

基　　金：河南省医学科技攻关计划(联合共建项目)(2018020898);河南省医学科技攻关计划(联合共建项目)(LHCJ20210866)。

摘　　要：目的探讨两个“半荷包”缝合包埋法在胃癌根治术中加固十二指肠残端的应用效果。方法回顾性分析2018年12月至2021年3月194例行胃癌根治术患者的临床资料,根据术中加固十二指肠残端的不同方法分为观察组和对照组,观察组为两个“半荷包”缝合包埋法(n=110例),对照组为浆肌层缝合包埋法(n=84例)。采用SPSS 25.0软件进行统计分析,两组患者围手术期各项指标以(x±s)表示,采用独立样本t检验;术后并发症(%)采用卡方检验。以P<0.05为差异有统计学意义。结果全部患者无死亡病例。十二指肠残端漏发生率观察组显著低于对照组(0%vs.3.6%,P=0.046)。十二指肠残端长度≤0.5 cm的构成比观察组显著高于对照组(27.3%vs.13.1%,P=0.016)。观察组十二指肠包埋时间显著短于对照组[(2.5±0.8)vs.(4.7±0.9)min,P<0.001]。结论采用两个“半荷包”缝合包埋法加固胃癌根治术中十二指肠残端可显著降低十二指肠残端漏的发生。且该方法包埋时间短,操作简单,同时可解决因十二指肠残端过短而包埋困难的情况。因此,该方法值得在胃癌手术中推广应用。Objective To investigate the effect of two“half pocket”suture embedding method in strengthening duodenal stump during radical gastrectomy of gastric cancer.Methods The clinical dataof 194 patients with gastric cancer who underwent radical gastrectomy from Decermber 2018 to March 2021 were retrospectively analyzed.According to different methods of strengthening duodenal stump during the operation,two“half-bag”suture embedding method were used in the observation group(110 cases),and sarcomuscular suture embedding method was used in the control group(84 cases).SPSS 25.0 software was used for statistical analysis,and the perioperative indicators(x±s)of the two groups were compared by independent sample t test,and postoperative complications(%)were compared byχ^(2)test.P<0.05 was considered to be statistically significant.Results None of the patients died.The incidence of duodenal stump leakage in the observation group was significantly lower than that in the control group(0%vs.3.6%,P=0.046).The ratio of duodenal stump length<0.5 cm in observation group was significantly higher than that in control group(27.3%vs.13.1%,P=0.016).Duodenal embedding time in the observation group was significantly shorter than that in the control group[(2.5±0.8)vs.(4.7±0.9)min,P<0.001].Conclusion The occurrence of duodenal stump leakage can be significantly reduced by using two“half pocket”suture embedding method to strengthen duodenal stump during radical gastrectomy.The embedding time of the method is short,the operation is simple,and the embedding difficulty caused by the short duodenal stump can be solved.Therefore,this method is worth popularizing and applying in gastric cancer surgery.

关 键 词：胃肿瘤 十二指肠残端漏 胃切除术 

分 类 号：R735.2[医药卫生—肿瘤]