摘要
目的探讨腹腔镜胃旁路手术方式中,胃后路胃空肠吻合手术方式的可行性和临床价值。方法 2010年12月～2012年3月,对体重指数(BMI)≥35.0的单纯性肥胖症病例行结肠后腹腔镜胃空肠Roux-en-Y吻合术,随意分组,胃后路径22例,胃前路径38例。对比2组手术时间、出血量、术后住院时间、术后近期并发症发生率,术后6个月体重、BMI、多余体重减除率(EWL%)的差异。结果胃后路组手术时间较胃前路组长[(157.2±9.2)min vs.(144.9±12.1)min,t=-4.127,P=0.000];2组术中出血量,术后住院时间,术后6个月体重、BMI、EWL%差异均无显著性。胃前路组8例(21%)术后出现呕吐等上消化道不全梗阻症状,均在1周内缓解;胃后路组未出现类似并发症(P=0.022)。结论胃后路腹腔镜胃旁路手术是一种可行的术式,相比胃前路术式更符合生理,术后胃肠道近期并发症较少,胃肠道功能恢复较快。
Objective To explore the feasibility and value of retro-gastric gastrojejunal anastomosis after laparoscopic gastric Roux-en-Y bypass. Methods A retrospective analysis on totally 60 patients with a simple obesity （ BMI /〉 35.0） , who underwent retro-gastric gastrojejunal anastomosis after laparoscopic gastric Roux-en-Y bypass in our hospital from December 2010 to March 2012. The patients were divided into two groups to receive retro （22 cases） and ante-gastric （38 cases） approaches respectively. The operation time, intraoperative blood loss, postoperative hospital stay and short-term rate of complications, as well as the weight and EWL% in 6 months after the procedure were compared between the two groups. Results The retro-gastric group showed significantly longer operation time than anti-gastric group （ 157.2 ± 9.2） min vs. （ 144.9± 12.1 ） min, t = - 4. 127, P = 0. 000 ]. No significant difference was detected in the intraoperative blood loss, postoperative hospital stay and the weight and EWL% in 6 months after the procedure between the two groups. In the ante-gastric group, 8 patients （21%） had vomit and other symptoms of incomplete obstruction of the upper digestive tract, which were all cured in one week; whereas, no such complications occurred in retro-gastric group （P = 0. 022）. Conclusion Retro-gastric laparoscopic gastric Roux-en-Y bypass is feasible, and better suits the patients ＇ physiological conditions than ante-gastric approach, and thus leads to less complications and quick recovery of gastrointestinal function.
出处
《中国微创外科杂志》
CSCD
2013年第2期123-126,共4页
Chinese Journal of Minimally Invasive Surgery
关键词
胃后路
胃旁路
腹腔镜
Retro-gastric
Gastric bypass
Laparoscopy
