腹腔镜全胃切除术中使用圆形吻合器或直线切割吻合器的效果比较  

Comparison of the Effects of Using Circular Cutting Stapler or Linear Cutting Stapler in Laparoscopic Total Gastrectomy

作　　者：王立阳 徐露[1] WANG Liyang;XU Lu(The First Affiliated Hospital of Soochow University,Suzhou 215006,China;不详)

机构地区：[1]苏州大学附属第一医院,江苏苏州215006

出　　处：《中外医学研究》2024年第34期156-160,共5页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:分析腹腔镜全胃切除术中使用圆形吻合器或直线切割吻合器的效果。方法:回顾性选取2016年1月1日—2021年12月31日苏州大学附属第一医院胃肠外科收治的284例胃癌患者。根据不同吻合器将其分为圆形吻合器组(n=185)和直线吻合器组(n=99)。圆形吻合器组在腹腔镜全胃切除术中使用圆形吻合器。直线吻合器组在腹腔镜全胃切除术中使用直线切割吻合器。比较两组病理情况,围手术期指标,并发症。结果:圆形吻合器组近切缘距离长于直线吻合器组,差异有统计学意义(P<0.05)。直线吻合器组辅助切口大小小于圆形吻合器组,差异有统计学意义(P<0.05)。圆形吻合器组发生并发症38例,直线吻合器组发生并发症15例。两组并发症发生率比较,差异无统计学意义(P>0.05)。结论:使用圆形吻合器或直线切割吻合器行腹腔镜全胃切除术中食管空肠吻合均是安全可行的。使用圆形吻合器行食管空肠吻合可使患者肿瘤近端切缘获益,但辅助切口更大。Objective:To compare the the effects of using circular cutting stapler or linear cutting stapler in laparoscopic total gastrectomy.Method:A total of 284 gastric cancer patients admitted to the Department of Gastrointestinal Surgery of the First Affiliated Hospital of Soochow University from January 1,2016 to December 31,2021 were retrospectively selected.They were divided into round stapler group(n=185)and straight stapler group(n=99)according to different staplers.The round stapler group used a circular cutting stapler during laparoscopic total gastrectomy.The straight stapler group used linear cutting staplers during laparoscopic total gastrectomy.The pathological conditions,perioperative indexes and complications were compared between the two groups.Result:The distance near the cutting edge of the circular stapler group was longer than that of the straight stapler group,and the differences were statistically significant(P<0.05).The auxiliary incision size of the straight stapler group was smaller than that of the circular stapler group,and the difference was statistically significant(P<0.05).38 cases of complications occurred in the circular stapler group,and 15 cases of complications occurred in the straight stapler group.There was no statistically significant difference in the incidence of complications between the two groups(P>0.05).Conclusion:The use of circular staplers or linear cutting staplers for esophagojejunal anastomosis in laparoscopic total gastrectomy is safe and feasible.Using a circular stapler for esophagojejunal anastomosis can benefit the proximal margin of the tumor in patients,but the auxiliary incision is larger.

关 键 词：胃癌 全胃切除术 圆形吻合器 直线切割吻合器 食管空肠吻合术 

分 类 号：R735.2[医药卫生—肿瘤]