腹腔镜近端胃切除术中圆锥形重叠吻合成形术对Siewert Ⅱ型AEG患者胃食管反流、营养状态的影响研究  

Effect of conical overlapping anastomoplasty during laparoscopic proximalgastrectomyon gastroesophageal reflux and nutritional status in Siewert type II AEG patients

作　　者：白浪[1] 张雪玉[1] 白铁成[1] 贺爱军[1] Bai Lang;Zhang Xueyu;Bai Tiecheng;He Ajun(Department of Gastrointestinal Surgery,Afiliated Hospital of Yan'an University,Yan'an Shaanxi Province 716000,China)

机构地区：[1]延安大学附属医院胃肠外科,陕西延安716000

出　　处：《中华普外科手术学杂志（电子版）》2024年第6期679-682,共4页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

基　　金：陕西省重点研发计划项目(2020SF-237)。

摘　　要：目的分析腹腔镜近端胃切除术中圆锥形重叠吻合成形术对SiewertⅡ型AEG患者胃食管反流、营养状态的影响。方法选取2020年1月至2023年8月42例SiewertⅡ型食管胃结合部腺癌患者,采用随机数字表法分为两组,每组患者各21例。所有患者均接受腹腔镜近端胃切除术,观察组患者术中行圆锥形重叠吻合成形术,对照组患者行双肌瓣吻合法。SPSS 24.0软件完成数据分析。计数资料用[例(%)]表示,比较行χ^(2)检验或秩和检验;计量资料用(χ±s)表示,行独立样本t检验。P<0.05为差异有统计学意义。结果观察组患者手术时间、术后首次排气时间、进食时间及住院时间均短于对照组,术中出血量少于对照组,差异有统计学意义(P<0.05);观察组患者术后3个月、6个月血红蛋白(HB)、血清白蛋白(ALB)和总蛋白(TP)水平显著高于对照组(P<0.05);观察组患者Visick分级明显优于对照组(P<0.05);两组患者并发症总发生率比较,差异无统计学意义(P>0.05)。结论SiewertⅡ型AEG行腹腔镜近端胃切除术中采用圆锥形重叠吻合成形术能够降低手术难度,减少手术时间及出血,促进患者术后营养吸收,利于恢复,且具有更好的抗反流效果。Objective To analyze the effects of conical overlapping anastomoplasty during endoscopic proximal gastrectomy on gastroesophageal reflux and nutritional status in Siewert typeⅡAEG patients.Methods Forty-two patients with Siewert typeⅡesophagogastric conjunctive adenocarcinoma from January 2020 to August 2023 were selected and divided into two groups by random number table method,with 21 patients in each group.All patients underwent laparoscopic proximal gastrectomy.Conical overlapping anastomosis was performed in the observation group,and double muscle flap anastomosis was performed in the control group.SPSS 24.0 completed data analysis.The count data is represented by[cases(%)],comparing the rowχ^(2) test or the Rank Sum test;Measurement data were represented by(χ±s)and independent sample t test was performed.P<0.05 was considered statistically significant.Results Operation time,first postoperative exhaust time,feeding time and hospitalization time in observation group were shorter than those in control group,and intraoperative blood loss was less than that in control group,the difference was statistically significant(P<0.05).The levels of hemoglobin(HB),serum albumin(ALB)and total protein(TP)in observation group were significantly higher than those in control group at 3 months and 6 months after operation(P<0.05);The Visick grade of the observation group was significantly better than that of the control group(P<0.05).There was no significant difference in the total incidence of complications between the two groups(P>0.05).Conclusion Conical overlapping anastomosis in laparoscopic proximal gastrectomy for Siewert typeⅡAEG can reduce surgical difficulty,reduce surgical time and bleeding,promote postoperative nutrient absorption of patients,facilitate recovery,and have better anti-reflux effects.

关 键 词：食管胃接合处 腺癌 腹腔镜 圆锥形重叠吻合成形术 胃食管反流 营养状况 

分 类 号：R735.2[医药卫生—肿瘤]