摘要
目的探讨Uncut Roux-en-Y吻合、Roux-en-Y吻合与Billroth-II吻合在远端胃癌根治术消化道重建中的应用效果。方法回顾性分析2016年1月至2019年1月94例行完全腹腔镜下胃癌根治术患者临床资料,根据不同消化道重建方式分组,其中A组28例行Uncut Roux-en-Y吻合、B组36例行Roux-en-Y吻合、C组30例行Billroth-II吻合。采用SPSS20.0统计软件进行数据分析,围术期指标等计量资料采用(■±s)表示,用单因素方差分析,组间两两比较采用t检验;术后并发症等计数资料采用χ^2检验。P<0.05为差异有统计学意义。结果A组在降低手术吻合时间和Roux淤滞综合征(RSS)明显优于B组(P<0.05);术中出血量和肛门恢复排气时间明显低于B组与C组(P<0.05);A组和B组在降低反流性胃炎和胆汁反流显著优于C组(P<0.05);在手术时间、恢复进食时间、术后住院时间、吻合口漏、溃疡、狭窄、出血及反流性食管炎等方面三组差异均无统计学意义(P>0.05)。结论Uncut Roux-en-Y吻合术在胃癌根治术中具有操作简单、安全可行、降低术后并发症等特点,有效改善患者术后生活质量,值得临床推广。
Objective To explore the effect of Uncut Roux-en-Y anastomosis,Roux-en-Y anastomosis and Billroth-II anastomosis in the reconstruction of digestive tract in laparoscopic radical distal gastrectomy.Methods 94 patients treated with complete laparoscopic radical gastrectomy from January 2016 to January 2019 were retrospectively analyzed,according to different digestive tract reconstruction methods they were divided into three groups.Among them,28 patients in group A treated with Uncut Roux-en-Y anastomosis,36 patients in group B treated with Roux-en-Y anastomosis,and 30 patients in group C treated with Billroth-II anastomosis.SPSS20.0 statistical software was used for data analysis.Perioperative indicators and other measurements were expressed by (■±s).One-way ANOVA was used to compare the two groups by t test.Postoperative complications and other counting data were compared byχ^2 test.Results The reduction of surgical anastomosis time and Roux-en-Y stasis syndrome(RSS)in group A was significantly better than those in group B(P<0.05).The intraoperative blood loss and anal recovery time were significantly lower than those in group B and Group C(P<0.05);the reducing reflux gastritis and bile reflux in group A and group B were significantly better than group C(P<0.05);There were no significant differences in the three groups in operative time,recovery time,postoperative hospital stay,anastomotic leakage.ulcer,stenosis,hemorrhage and reflux esophagitis(P>0.05).Conclusion Uncut Roux-en-Y anastomosis is simple,safe and feasible,and reduces postoperative complications in gastric cancer radical surgery.It is effective in improving postoperative quality of life and is worthy of clinical promotion.
作者
张涛
马海婧
Zhang Tao;Ma Haijing(Xi’an third hospital,710018;Xianyang first people’s hospital,712000)
出处
《中华普外科手术学杂志（电子版）》
2020年第4期407-410,共4页
Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)
基金
陕西省科学技术厅重点研发计划(2017JM0065)。
关键词
胃肿瘤
腹腔镜
吻合术
Roux-en-Y
消化道重建
Stomach neoplasms
Laparoscopes
Anastomosis,roux\|en\|y
Digestive tract reconstruction
