不同吻合方案在腹腔镜远端胃癌根治术患者中的应用效果  

Application effect of different anastomosis methods in patients undergoing laparoscopic distal gastrectomy

作　　者：王钧[1] 王耿泽[1] 张虎 裴正浩 郝阳 WANG Jun;WANG Gengze;ZHANG Hu;PEI Zhenghao;HAO Yang(Ward 1,Department of Gastrointestinal Surgery,Nanyang Central Hospital,Nanyang 473000,He’nan,China)

机构地区：[1]南阳市中心医院胃肠外科一病区,河南南阳473000

出　　处：《癌症进展》2023年第16期1831-1834,共4页Oncology Progress

摘　　要：目的探讨BillrothⅡ吻合术和非离断式Roux-en-Y吻合术在腹腔镜远端胃癌根治术患者中的应用效果。方法根据吻合方案的不同将90例腹腔镜远端胃癌根治术患者分为A组(n=41,BillrothⅡ吻合术)和B组(n=49,非离断式Roux-en-Y吻合术)。比较两组患者的术中指标、术后恢复进程指标、营养指标、术后近期和远期并发症发生情况。结果B组患者手术时间、消化道重建时间均短于A组,术中出血量少于A组,差异均有统计学意义(P﹤0.05)。B组患者进流食时间、进半流食时间、首次排气时间、引流管拔除时间及住院时间均明显短于A组,差异均有统计学意义(P﹤0.01)。两组患者术后近期并发症总发生率比较,差异无统计学意义(P﹥0.05)。术后6个月,B组患者总蛋白、白蛋白水平均高于A组,差异均有统计学意义(P﹤0.05)。术后1年,B组患者胆汁反流、吻合口溃疡发生率均低于A组,差异均有统计学意义(P﹤0.05)。结论非离断式Roux-en-Y吻合术可缩短腹腔镜远端胃癌根治术患者的消化道重建时间及手术时间,减少术中出血量,促进患者术后恢复,改善营养状态,降低远期并发症发生率。Objective To investigate the application effect of Billroth II anastomosis and uncut Roux-en-Y anastomosis in patients with laparoscopic distal gastrectomy.Method A total of 90 patients with laparoscopic distal gastrectomy were divided into group A(n=41,Billroth II anastomosis)and group B(n=49,uncut Roux-en-Y anastomosis)according to different anastomosis methods.The intraoperative indicators,postoperative recovery process indicators,nutritional indicators,and short-term and long-term postoperative complications were compared between the two groups.Result The operation time and digestive tract reconstruction time in group B were shorter than those in group A,and the intraoperative blood loss was less than that in group A,and the differences were statistically significant(P<0.05).The time of liquid food intake,semi-liquid food intake,first exhaust time,drainage tube removal time,and hospital stay in group B were significantly shorter than those in group A,and the differences were statistically significant(P<0.01).There was no significant difference in the total incidence of postoperative short-term complications between the two groups(P>0.05).Six months after the operation,the levels of total protein and albumin in group B were higher than those in group A,and the differences were statistically significant(P<0.05).One year after the operation,the incidences of bile reflux and anastomotic ulcer in group B were lower than those in group A,and the differences were statistically significant(P<0.05).Conclusion Uncut Roux-en-Y anastomosis could shorten the digestive tract reconstruction time and operation time of patients undergoing laparoscopic distal gastrectomy,reduce intraoperative blood loss,promote postoperative recovery,improve nutritional status,and reduce the risk of long-term complications.

关 键 词：腹腔镜远端胃癌根治术 非离断式Roux-en-Y吻合术 BillrothⅡ吻合术 营养指标 

分 类 号：R735.2[医药卫生—肿瘤]