摘要
目的:探讨非离断(Uncut)Roux-en-Y吻合术在腹腔镜远端胃癌根治术消化道重建中的临床应用。方法:回顾性分析2019年1月-2021年12月在南京医科大学附属无锡第二医院接受远端胃癌根治手术的79例患者的临床资料。根据消化道重建方式的不同分为对照组(n=30)和观察组(n=49)。对照组行Roux-en-Y吻合术,观察组行Uncut Roux-en-Y吻合术。比较两组围手术期情况和并发症,术后3个月Roux-en-Y滞留综合征(RSS)、残胃炎和胆汁反流发生率及营养状况。结果:与对照组比较,观察组消化道重建时间、首次排气时间均明显缩短,差异均有统计学意义(P<0.05)。两组围手术期并发症发生率比较,差异无统计学意义(P>0.05)。术后3个月,观察组RSS、残胃炎和胆汁反流发生率均明显低于对照组,差异均有统计学意义(P<0.05)。术后3个月,观察组总蛋白、白蛋白和血红蛋白水平均高于对照组,差异均有统计学意义(P<0.05)。结论:Uncut Roux-en-Y吻合术能够缩短消化道重建时间,降低术后RSS、残胃炎和胆汁反流发生率,改善营养状况。
Objective: To investigate the clinical application of Uncut Roux-en-Y anastomosis in digestive tract reconstruction after laparoscopic radical resection of distal gastric cancer. Method: The clinical data of 79patients who underwent laparoscopic radical resection of distal gastric cancer in Wuxi Second Hospital Affiliated to Nanjing Medical University from January 2019 to December 2021 retrospectively analyzed. They were divided into control group(n=30) and observation group(n=49) according to the different ways of digestive tract reconstruction.Roux-en-Y anastomosis was performed in the control group and Uncut Roux-en-Y anastomosis was performed in the observation group. The perioperative conditions and complications, the incidence of Roux-en-Y retention syndrome(RSS), residual gastritis and bile reflux three months after surgery, and the nutritional status after surgery were compared between the two groups. Result: Compared with the control group, the digestive tract reconstruction time and the first exhaust time in the observation group were significantly shortened, the differences were statistically significant(P<0.05). There was no significant difference in the incidence of perioperative complications between the two groups(P>0.05). Three months after surgery, the incidences of RSS, residual gastritis and bile reflux in the observation group were significantly lower than those in the control group(P<0.05). Three months after surgery, the levels of total protein, albumin and hemoglobin in the observation group were higher than those in the control group,the differences were statistically significant(P<0.05). Conclusion: Uncut Roux-en-Y anastomosis can shorten the time of digestive tract reconstruction, reduce the incidence of RSS, residual gastritis and bile reflux, and help improve nutritional status.
作者
张翔
周云海
周宏
徐伟
ZHANG Xiang;ZHOU Yunhai;ZHOU Hong;XU Wei(Wuxi Second Hospital Affiliated to Nanjing Medical University,Wuxi 214001,China;不详)
出处
《中国医学创新》
CAS
2023年第2期1-5,共5页
Medical Innovation of China
关键词
远端胃癌根治术
消化道重建
非离断Roux-en-Y吻合术
Radical resection of distal gastric cancer
Digestive tract reconstruction
Uncut Roux-en-Y anastomosis
