uncut-Roux-en-Y吻合术在远端胃癌腹腔镜D2根治术患者中的应用效果  

Application effect of uncut-Roux-en-Y anastomosis in laparoscopic D Y anastomosis in laparoscopic D2 radical surgery for distal gastric cancer patients

作　　者：胡海洋 杨剑 吴卫东 程波 HU Haiyang;YANG Jian;WU Weidong;CHENG Bo(Department of Vascular Surgery,Jiujiang Third People’s Hospital,Jiujiang 332000,Jiangxi,China;Department of Pathology,Jiujiang Third People’s Hospital,Jiujiang 332000,Jiangxi,China)

机构地区：[1]九江市第三人民医院血管外科,江西九江3320000 [2]九江市第三人民医院病理科,江西九江3320000

出　　处：《癌症进展》2024年第22期2486-2489,共4页Oncology Progress

摘　　要：目的 探讨uncut-Roux-en-Y吻合术在远端胃癌腹腔镜D2根治术患者中的应用效果。方法 选取87例胃癌患者,均行腹腔镜D2根治术,根据吻合术式的不同分为观察组(n=45)和对照组(n=42),观察组患者采用uncut-Roux-en-Y吻合术进行消化道重建,对照组患者采用BillrothⅡ吻合术进行消化道重建。比较两组患者术中指标、术后恢复指标、营养指标[白蛋白(ALB)、血红蛋白(Hb)和转铁蛋白(TRF)]和术后并发症发生情况。结果观察组患者手术时间、住院时间均短于对照组,差异均有统计学意义(P﹤0.05);两组患者消化道重建时间、术中出血量、首次通气时间、胃管拔除时间比较,差异均无统计学意义(P﹥0.05)。术后,两组患者ALB、Hb和TRF水平均高于本组术前,观察组患者ALB水平高于对照组,差异均有统计学意义(P﹤0.05);两组患者Hb、TRF水平比较,差异均无统计学意义(P﹥0.05)。两组患者术后均未发生感染,观察组患者的并发症总发生率为11.11%,低于对照组患者的30.95%,差异有统计学意义(P﹤0.05)。结论 在远端胃癌患者腹腔镜D2根治术中应用uncut-Roux-en-Y吻合术进行消化道重建,不仅有利于缩短手术时间和住院时间,还能有效改善患者术后营养状态,减少术后并发症。Objective To investigate the application effect of uncut-Roux-en-Y anastomosis in laparoscopic D2 radi-cal surgery for distal gastric cancer patients.Method A total of 87 patients with gastric cancer were selected and under-went laparoscopic D2 radical surgery.They were divided into observation group(n=45)and control group(n=42)accord-ing to the different anastomosis methods.The observation group underwent uncut-Roux-en-Y anastomosis for gastrointes-tinal reconstruction,while the control group underwent Billroth II anastomosis for gastrointestinal reconstruction.The in-traoperative indexes,postoperative recovery indexes,nutritional indexes[albumin(ALB),hemoglobin(Hb)and transfer-rin(TRF)]and incidence of postoperative complications were compared between the two groups.Result The surgical time and hospitalization time in the observation group were shorter than those in the control group,and the differences were statistically significant(P<0.05);there were no statistically significant differences in the reconstruction time of the digestive tract,intraoperative bleeding volume,first ventilation time,and gastric tube removal time between the two groups(P>0.05).After surgery,the levels of ALB,Hb,and TRF in both groups were higher than before surgery,the ALB level in the observation group was higher than that in the control group,and the differences were statistically significant(P<0.05);there were no statistically significant differences in Hb and TRF levels between the two groups(P>0.05).Both groups did not experience infection after surgery,the total incidence of complications in the observation group was 11.11%,which was lower than 30.95%in the control group,and the difference was statistically significant(P<0.05).Conclusion The uncut-Roux-en-Y anastomosis for gastrointestinal reconstruction in laparoscopic D2 radical surgery for distal gastric cancer patients not only helps to shorten the operation time and hospitalization time,but also effectively im-proves the postoperative nutritional status of patients and red

关 键 词：远端胃癌 腹腔镜D2根治术 吻合技术 营养状态 并发症 

分 类 号：R735.2[医药卫生—肿瘤]