摘要
目的探讨非离断式Roux-en-Y吻合在腹腔镜辅助远端胃癌D2根治术中的临床效果。方法回顾性分析65例行腹腔镜远端胃癌D2根治术患者的临床资料,其中行非离断式Roux-en-Y吻合的患者31例(观察组),行传统Roux-en-Y吻合的患者34例(对照组)。比较2组患者消化道重建时间和肛门恢复排气时间,及术后吻合口/残端漏、吻合口炎/溃疡、肿瘤复发/转移和Roux-en-Y滞留综合征(RSS)发生情况。结果观察组消化道重建时间和肛门恢复排气时间分别为(46.19±4.20)min、(50.32±4.64)h,对照组分别为(49.32±4.44)min、(53.38±4.74)h,观察组消化道重建时间和肛门恢复排气时间均短于对照组(均P<0.05)。观察组发生RSS 1例,而对照组为10例,观察组优于对照组(P<0.05)。在吻合口/残端漏、吻合口炎/溃疡、肿瘤复发/转移方面,2组比较差异无统计学意义(P>0.05)。结论非离断式Roux-en-Y吻合用于腹腔镜远端胃癌D2根治术可缩短手术时间及肛门排气时间,同时减少RSS发生率,是一种安全有效的方法。
Objective To investigate the clinical effect of uncut Roux-en-Y anastomosis in laparoscopic-assisted radical D2 gastrectomy for distal gastric cancer.Methods Clinical data of 65 patients who underwent laparoscopic-assisted radical D2 gastrectomy for distal gastric cancer were retrospectively analyzed.Among them,31 received uncut Roux-en-Y anastomosis(observation group)and 34 received conventional Roux-en-Y anastomosis(control group).Digestive tract reconstruction time,anal flatus recovery time,postoperative anastomotic/stump leakage,anastomotic inflammation/ulcer,tumor recurrence/metastasis and Roux-en-Y stasis syndrome(RSS)were compared between the two groups.Results Compared with conventional Roux-en-Y anastomosis,uncut Roux-en-Y anastomosis significantly shortened digestive tract reconstruction time((46.19±4.20)minutes vs(49.32±4.44)minutes)and anal flatus recovery time((50.32±4.64)hours vs(53.28±4.74)hours)(P<0.05).The incidence of RSS in observation group(1 case)was lower than that in control group(10 cases)(P<0.05).There were no significant differences between the two groups in postoperative anastomotic/stump leakage,anastomotic inflammation/ulcer and tumor recurrence/metastasis(P>0.05).Conclusion As a safe and effective method,uncut Roux-en-Y anastomosis can shorten digestive tract reconstruction time and anal flatus recovery time and reduce the incidence of RSS in laparoscopic-assisted radical D2 gastrectomy for distal gastric cancer.
作者
黄锋明
张炎彬
王树钦
HUANG Feng-ming;ZHANG Yan-bin;WANG Shu-qin(Department of General Surgery,Jieyang People’s Hospital,Jieyang 522000,China)
出处
《实用临床医学（江西）》
CAS
2020年第5期35-38,共4页
Practical Clinical Medicine
