摘要
目的:比较Overlap吻合与π吻合在全腹腔镜全胃切除术(TLTG)中的应用效果.方法:选择2019年2月至2022年2月在成都市第五人民医院行TLTG的胃癌患者98例,根据食管空肠吻合方式分为Overlap吻合组(n=56)和π吻合组(n=42).比较两组围手术期指标(手术时间、吻合时间、术中出血量、淋巴结清扫数目、术后肛门排气时间、术后拔除引流管时间、术后住院时间、肿瘤上缘至食管切缘距离),吻合口相关并发症(吻合口出血、吻合口狭窄、吻合口漏)与随访并发症(吻合口溃疡、倾倒综合征、反流性食管炎、营养不良)发生情况,以及术前与术后3个月整体营养状况主观评估量表(PG-SGA)评分与营养状况客观指标(血红蛋白、白蛋白、总蛋白)水平的变化.结果:Overlap 吻合组手术时间[(230.36±25.12)min vs(205.58±20.43)min]、吻合时间[(43.22±6.15)min vs(27.45±5.36)min]均长于π吻合组(P＜0.05);两组吻合口相关并发症、随访并发症发生率及术前、术后3个月PG-SGA量表评分与营养状况客观指标水平的变化差异均无统计学意义(P＞0.05).结论:Overlap吻合和π吻合在TLTG术中各有优势,π吻合可缩短手术时间和吻合时间.
Abstract
Aim:To compare the efficacy of Overlap anastomosis and π anastomosis in totally laparoscopic total gas-trectomy(TLTG).Methods:Totally 98 patients with gastric cancer receiving TLTG between February 2019 and February 2022 were retrospectively analyzed.According to esophagojejunal anastomosis methods,the patients were allocated into O-verlap anastomosis group(n=56)and π anastomosis group(n=42).The perioperative indicators(surgical time,anastomo-sis time,intraoperative blood loss,number of lymph node dissection,postoperative anal exhaust time,postoperative drainage tube removal time,postoperative hospital stay,distance from the upper tumor margin to the esophagotomy margin),anasto-motic-related complications(anastomotic bleeding,anastomotic stenosis and anastomotic leakage)and follow-up complications(anastomotic ulcer,dumping syndrome,reflux esophagitis,malnutrition),as well as the difference values of Patient-Generated Subjective Global Assessment(PG-SGA)scores and objective indicators of nutritional status(hemoglobin,albumin,total protein)before surgery and at 3 months after surgery were compared between the 2 groups.Results:The surgical time and anastomosis time in Overlap group were longer than those in π anastomosis group[(230.36±25.12)min vs(205.58±20.43)min,(43.22±6.15)min vs(27.45±5.36)min,P＜0.05].There were no statistical differences in the inci-dence rates of anastomotic-related complications or follow-up complications,the difference values of scores of PG-SGA,or the levels of objective indicators of nutritional status before surgery and at 3 months after surgery(P＞0.05).Conclusion:Overlap anastomosis and π anastomosis have their respective advantages during TLTG,while π anastomosis can shorten the surgical time and anastomosis time.
基金项目
四川省医学会伤口疾病(泰阁)专项科研课题(2021TG38)
维普
万方数据