一种高度仿生的改良食管胃吻合术在近端胃切除消化道重建中的安全性及疗效分析  

Safety and efficacy analysis of a highly biomimetic modified esophagogastric anastomosis in gastrointestinal reconstruc⁃tion of proximal gastrectomy

作　　者：颜宇轩 田立涛 王泽鑫 李希斌 王金申 YAN Yu-xuan;TIAN Li-tao;WANG Ze-xin;LI Xi-bin;WANG Jin-shen(Department of Gastrointestinal Surgery,Shandong Provincial Hospital Affiliated to Shandong First Medical University,Jinan 250021,China)

机构地区：[1]山东第一医科大学附属省立医院胃肠外科,山东济南250021

出　　处：《中国现代普通外科进展》2024年第9期694-698,共5页Chinese Journal of Current Advances in General Surgery

基　　金：青海省卫生健康系统重点课题(2021-wjzd-06)。

摘　　要：目的:探讨一种高度仿生的改良食管胃吻合方式在近端胃切除术后消化道重建中的安全性及抗反流效果,以期为近端胃切除术后消化道重建提供一种安全简单且具有良好抗反流效果的新选择。方法:将2022年1月—2023年9月于山东第一医科大学附属省立医院胃肠外科行近端胃切除术后采用改良食管胃吻合术患者30例(研究组)与同期行目前公认的抗反流效果较好的双通道吻合术27例患者(对照组)进行对比分析,主要对比手术相关指标、手术后生活质量、术后并发症、手术的抗反流效果等。结果:在手术时间和术后住院时间上,研究组明显优于对照组,差异有统计学意义(P<0.05);而在术中出血量和手术的抗反流效果方面,两种吻合方法表现相似,差异无统计学意义(P>0.05);在术后并发症方面,研究组术后吻合口瘘和肠梗阻的发生率较对照组稍低,但就总发生率而言,两者差异无统计学意义(P>0.05);在术后生活质量方面,两组差异无统计学意义(P>0.05)。结论:高度仿生的改良食管胃吻合术在治疗食管胃结合部腺癌是安全的、可行的,且具有良好的抗反流效果,但该术式还需进一步高质量的随机对照研究并进行深入探讨。Objective:To investigate the safety and anti-reflux effect of a highly bionic modified esophagogastric anastomosis in the reconstruction of the digestive tract after proximal gastrectomy,with the aim of providing a safe and simple new option with good anti-reflux effect for the reconstruction of the digestive tract after proximal gastrectomy.Methods:In this retrospective study,30 patients(Study group)who underwent modified esophagogastric anastomosis after proximal gastrectomy in the Department of Gastrointestinal Surgery of Shandong Provincial Hospital Affiliated to Shandong First Medical University from January 2022 to September 2023 were compared with 27(Control group)patients who underwent double-tract reconstruction which is currently recognized as having good anti-reflux effect during the same period,the main compari-sons were made between the surgery-related indexes,the quality of life after the surgery,the postoperative complications,and the anti-reflux effect of the surgery.Results:The study group was significantly better than the control group in terms of operation time and postoperative hospi-talization time,with statistically significant differences(P<0.05),and the difference between the two groups was comparable in terms of intraoperative bleeding and the anti-reflux effect of the opera-tion,with no statistically significant differences(P>0.05);in terms of postoperative complications,the incidence of anastomotic fistula and intestinal obstruction was slightly lower in the study group compared with the control group,but in terms of total incidence,the difference was not statistically significant;in terms of quality of life,the difference was not statistically significant when comparing the quality of life of the two groups after treatment(P<0.05).Conclusion:Highly bionic modified esophagogastric anastomosis is safe and feasible in the treatment of adenocarcinoma of the esophagogastric junction with excellent anti-reflux effect,but the procedure needs further high quality randomized controlled studies

关 键 词：胃食管交界区腺癌 近端胃切除术 消化道重建术 胃食管反流 

分 类 号：R735.2[医药卫生—肿瘤]