摘要
目的比较Roux-en-Y吻合术和间置空肠手术在近端胃癌手术治疗中效果。方法 151例近端胃癌患者,行近端胃部分切除＋间置空肠吻合术69例为观察组,全胃切除＋Roux-en-Y吻合术82例为对照组,观察2组术后肺部感染、吻合口瘘、反流性食管炎、切口感染等并发症发生情况,比较2组术后生活质量Visick分级,以及术后1、3、5a患者生存率。结果 2组患者手术过程均顺利,观察组术后反流性食管炎发生率（26.1%）低于对照组（73.2%）（P〈0.05）,2组术后感染、吻合口瘘或吻合口出血、肠梗阻发生率比较差异均无统计学意义（P〉0.05）;观察组术后Visick分级1~2级比率（89.9%）高于对照组（45.1%）（P〈0.05）,术后1、3、5a生存率（97.1%、60.9%、46.4%）与对照组（90.2%、68.3%、48.8%）比较差异均无统计学意义（P〉0.05）。结论近端胃切除＋间置空肠吻合术和全胃切除＋Roux-en-Y吻合术治疗近端胃癌疗效确切,前者消化道重建方式有助于提高术后生活质量,降低反流性食管炎发生率,可作为近端胃癌首选消化道重建方式。
Objective To compare the operation outcomes of Roux-en-Y anastomosis and jejunal interposition reconstructions for proximal gastric cancer.Methods In 151 patients with proximal gastric cancer,69 patients received proximal gastrectomy ＋ jejunal interposition reconstruction（observation group）and 82 patients received total gastrectomy ＋ Roux-en-Y anastomosis（control group）. The incidences of postoperative pulmonary infection,anastomotic leakage,reflux esophagitis,incision infection and other complications were observed,and the postoperative quality life（Visick grade）as well as the 1-,3-and 5-year survival rates were compared between two groups.Results Both two groups fulfilled operation smoothly.The incidence of reflux esophagitis was significantly lower in observation group（26.1%）than that in control group（73.2%）（P〈0.05）.There were no significant differences in the incidences of postoperative infection,anastomotic leakage or anastomotic bleeding,and intestinal obstruction between two groups（P〉0.05）.The rate of Visick grade 1to 2was significantly higher in observation group（89.9%）than that in control group（45.1%）（P〈0.05）.There were no significant differences in the postoperative 1-,3-and 5-year survival rates between observation group（97.1%,60.9%,46.4%）and control group（90.2%,68.3%,48.8%）（P〉0.05）.Conclusion Both proximal gastrectomy ＋jejunal interposition reconstruction and total gastrectomy ＋ Roux-en-Y anastomosis have curative effect on proximal gastric cancer,and the former operation can improve postoperative quality life of the patients and decrease the incidence of reflux esophagitis,and could be the first choice for digestive tract reconstruction for proximal gastric cancer.
出处
《中华实用诊断与治疗杂志》
2016年第12期1219-1221,共3页
Journal of Chinese Practical Diagnosis and Therapy
基金
黑龙江省博士后资助基金(LBH-Z09007)
黑龙江省科技计划项目攻关课题(GC09C405-3)
关键词
近端胃癌
反流
生存期
生活质量
Proximal gastric cancer
reflux
survival time
quality of life
