摘要
目的系统评价BillrothⅡ式与BillrothⅡ式联合Braun吻合重建术在腹腔镜远端胃癌根治术中的临床疗效差异。方法计算机检索CNKI、VIP、万方数据库、PubMed、Embase、Web of Science等,收集国内外公开发表关于两种消化道重建方式在腹腔镜远端胃癌根治术中比较的临床应用研究。检索时限为2000年1月至2022年10月。对纳入的临床研究进行质量评价及数量提取,并采用Cochrane协作网提供的RevMan5.3统计软件进行Meta分析。结果共纳入9项符合标准的研究,共1483例患者。Meta分析结果显示:在腹腔镜远端胃癌根治术中使用单纯BillrothⅡ式吻合手术时间及消化道重建时间短、术中出血量少,但使用BillrothⅡ联合Braun吻合住院时间短、近期总并发症少、远期反流性疾病少、远期营养状况好,差异均有统计学意义(P<0.05)。而淋巴结清扫数量、首次排气排便时间及部分短期并发症,差异无统计学意义(P>0.05)。结论腹腔镜远端胃癌根治术中,与单纯BillrothⅡ吻合相比,应用BillrothⅡ式联合Braun重建消化道,虽延长手术时间并增加术中出血量,但能减少患者术后近、远期并发症,减少术后住院时间,改善患者远期营养状况,临床应用具有一定优势。
Objective To systematically evaluate the clinical efficacy of BillrothⅡand BillrothⅡcombined with Braun anastomotic reconstruction in laparoscopic radical gastrectomy of distal gastric cancer.Methods CNKI,VIP,Wanfang database,PubMed,Embase,and Web of Science were searched by computer to collect the clinical application studies on the comparison of two kinds of digestive tract reconstruction methods in laparoscopic radical gastrectomy of distal gastric cancer.The search period was from January 2000 to October 2022.The included clinical studies were evaluated for quality and quantitative extraction,and Meta-analysis was performed using RevMan5.3 statistical software provided by the Cochrane Collaboration network.Results A total of 9 studies meeting the criteria were included,with a total of 1483 patients.The results of the Meta-analysis showed that in laparoscopic radical gastrectomy for distal gastric cancer,the operation time and digestive tract reconstruction time of BillrothⅡanastomosis alone were short,and the amount of intraoperative blood loss was less(P<0.05),but BillrothⅡcombined with Braun had a shorter hospital stay,fewer near-term complications,less long-term reflux disease and better long-term nutritional status(P<0.05).There were no significant differences in the number of lymph node dissections,the time of first defecation,and part of short-term complications.Conclusions The application of BillrothⅡcombined with Braun to rebuild the digestive tract in laparoscopic radical gastrectomy for distal gastric cancer may prolong the operation time and increase the amount of intraoperative blood loss,compared with the pure anastomosis of BillrothⅡ,but it can reduce the postoperative near-and long-term complications,reduce the postoperative hospital stay,and improve the long-term nutritional status of patients,which has certain advantages in clinical application.
作者
何凡
陈德飞
杨福宇
唐成林
钱昆
HE Fan;CHEN Defei;YANG Fuyu;TANG Chenglin;QIAN Kun(Department of Gastrointestinal Surgery,The First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China)
出处
《中国肿瘤外科杂志》
CAS
2024年第1期28-36,共9页
Chinese Journal of Surgical Oncology
基金
2023年重庆卫生适宜技术推广项目(2023istg023)。
