近端胃切除术后程氏Giraffe重建术的疗效分析  

Efficacy analysis of Cheng's Giraffe reconstruction after proximal gastrectomy

作　　者：张延强 徐志远[1] 余建法 胡灿 程向东[1] Zhang Yanqiang;Xu Zhiyuan;Yu Jianfa;Hu Can;Cheng Xiangdong(Department of Gastric Surgery,Zhejiang Cancer Hospital,Hangzhou 310022,China)

机构地区：[1]浙江省肿瘤医院胃外科,浙江杭州310022

出　　处：《腹部外科》2024年第2期101-105,共5页Journal of Abdominal Surgery

基　　金：浙江省中医药科技计划项目(2022ZQ020);浙江省卫生健康委员会医药卫生计划项目(2022KY684)。

摘　　要：目的比较胃食管结合部癌行根治性近端胃切除术后程氏Giraffe重建和双通道重建两种手术方式的近期临床疗效,评价程氏Giraffe重建术的疗效。方法回顾性分析浙江省肿瘤医院胃外科2018年9月1日至2023年9月1日行近端胃切除术125例病人,其中程氏Giraffe重建术91例,双通道重建术34例。观察指标包括:手术情况(手术时间、重建时间、术中出血量)、术后情况(术后住院天数、术后引流时间、检出淋巴结数、Clavien-Dindo≥3级并发症发生率、吻合口漏发生率及吻合口狭窄发生率)以及随访情况(术后胃食管反流发生率、术后1年血红蛋白及血清白蛋白情况)。结果两组病人基线资料的比较,差异无统计学意义(均P>0.05),具有可比性。两组术中出血量、术后住院天数、术后引流时间、检出淋巴结数、Clavien-Dindo≥3级并发症发生率、吻合口漏发生率及吻合口狭窄发生率的比较,差异均无统计学意义(均P>0.05)。与双通道重建组比较,程氏Giraffe重建组重建时间(P<0.001)及手术时间较短(P=0.036)。两组术后1年胃食管反流发生率、术后1年血红蛋白及血清白蛋白差异均无统计学意义(均P>0.05)。结论近端胃术后行程氏Giraffe重建临床疗效与双通道重建相当,操作简单,是胃食管结合部癌近端胃切除术后较为合理的重建方式之一。Objective To compare the short-term clinical effects of Cheng's Giraffe reconstruction and dual-channel reconstruction after radical proximal gastrectomy for gastroesophageal junction cancer and evaluate the efficacy of Cheng's"Giraffe"reconstruction.Methods From September 1,2018 to September 01,2023,125 patients undergoing proximal gastrectomy were reviewed retrospectively.Cheng's Giraffe reconstruction(n=91)and double channel reconstruction(n=34)were performed.The relevant observation parameters included operation(operative duration,reconstruction time&intraoperative blood loss),postoperative status(postoperative hospitalization stay,postoperative drainage time,number of detected lymph nodes,incidence of Clavien-Dindo≥3 complications,incidence of anastomotic leakage and anastomotic stricture)and follow-ups(incidence of gastroesophageal reflux,hemoglobin and serum albumin at Year 1 post-operation).Results No significant inter-group differences existed in baseline profiles(all P>0.05).No significant inter-group differences existed in volume of intraoperative blood loss,postoperative hospitalization stay,postoperative drainage time,the number of lymph nodes detected,the incidence of complications of Clavien-Dindo≥3,the incidence of anastomotic leakage and anastomotic stenosis.As compared with PG-DT group,reconstruction time(P<0.001)and operative duration(P=0.036)were shorter in PG-Giraffe group.No significant inter-group differences existed in incidence of gastroesophageal reflux,hemoglobin or serum albumin at Year 1 post-operation(P>0.05).Conclusion After proximal gastrectomy for gastroesophageal junction cancer,clinical efficacy of Cheng's Giraffe reconstruction is similar to that of dual-channel reconstruction and operation is simple.It is an ideal approach of reconstruction.

关 键 词：胃癌 近端胃切除术 消化道重建 

分 类 号：R656.6[医药卫生—外科学]