改良三角吻合技术在腹腔镜胃癌根治术中的应用研究  

Application study of modified delta-shaped anastomosis in laparoscopic radical gastrectomy

作　　者：简文红 劳景茂[1] 纪建波[1] JIAN Wenhong;LAO Jingmao;JI jianbo(Department of Gastrointestinal Surgery,the First People's Hospital of Qinzhou,Qinzhou City,Guangxi Zhuang Autonomous Region,535000,China)

机构地区：[1]广西壮族自治区钦州市第一人民医院胃肠外科,广西钦州535000

出　　处：《蛇志》2025年第1期71-75,共5页Journal of Snake

基　　金：广西壮族自治区临床重点专科建设项目(项目名称:广西临床重点专科建设项目(普通外科),项目编号:桂卫医发[2022]17号)。

摘　　要：目的探讨改良三角吻合技术在腹腔镜胃癌根治术中的应用效果。方法采用随机数字表法将2019年6月至2020年10月在我院择期行腹腔镜胃癌根治术的60例胃癌患者进行分组,A组30例患者实施Billroth-Ⅰ式吻合术,B组30例患者实施改良三角吻合术。比较两组手术指标、术后恢复情况以及术后7 d反流情况、免疫功能,并比较术后1个月并发症发生情况。结果B组的手术时间、吻合时间短于A组,术中出血量少于A组,差异均有统计学意义(均P<0.05)。B组患者的镇痛时间、肛门排气时间、进流食时间及住院时间均短于A组,差异均有统计学意义(均P<0.05)。术后7 d,B组Ⅰ级反流发生率高于A组,Ⅱ级反流发生率低于A组,差异均有统计学意义(均P<0.05)。术后7 d,B组的免疫球蛋白A(IgA)、免疫球蛋白M(IgM)、免疫球蛋白G(IgG)水平均高于A组,差异均有统计学意义(均P<0.05)。术后1个月时,B组的并发症发生率低于A组,差异有统计学意义(P<0.05)。结论在腹腔镜胃癌根治术中应用改良三角吻合技术能够优化手术指标,加快患者康复进程,减少术后反流,提高患者免疫能力,降低术后并发症发生率。Objective To investigate the application effect of modified triangular anastomosis technique in laparoscopic radical gastrectomy.Methods A total of 60 patients with gastric cancer who underwent laparoscopic radical gastrectomy in our hospital from June 2019 to October 2020 were divided into groups by random number table method.30 patients in group A underwent Billroth-Ⅰanastomosis,and 30 patients in group B underwent improved triangular anastomosis.The surgical indexes,postoperative recovery,postoperative reflux,immune function and complications on the 5th day after surgery were compared between the two groups.Results The operative time and anastomosis time of group B were shorter than those of group A,and the intraoperative blood loss was less than that of group A,with statistical significance(all P<0.05).The analgesia time,anal exhaust time,liquid feeding time and hospital stay in group B were shorter than those in group A,and the differences were statistically significant(all P<0.05).On the 7th day after surgery,the incidence of gradeⅠreflux in group B was higher than that in group A,and the incidence of gradeⅡreflux was lower than that in group A,with statistical significance(all P<0.05).Compared with the immune function indexes of the two groups,the levels of immunoglobulin A(IgA),immunoglobulin M(IgM)and immunoglobulin G(IgG)in group B were higher than those in group A,and the differences were statistically significant(all P<0.05).On the 5th day after surgery,the complication rate of group B was lower than that of group A,the difference was statistically significant(P<0.05).Conclusion The application of modified triangular anastomosis technique in laparoscopic radical gastrectomy for gastric cancer can optimize the surgical indicators,accelerate the rehabilitation process of patients,reduce postoperative reflux,improve the immune capacity of patients,and reduce the incidence of postoperative complications.

关 键 词：胃癌根治术 改良三角吻合技术 腹腔镜 Billroth-Ⅰ式吻合术 康复进程 并发症发生率 

分 类 号：R735.2[医药卫生—肿瘤]