首页|全腹腔镜下食管-空肠π吻合在贲门癌根治术中的近期安全性研究

全腹腔镜下食管-空肠π吻合在贲门癌根治术中的近期安全性研究

Short term safety research of total laparoscopic π-shaped esophagojejunal anastomosis in radical surgery for adenocarcinoma of esophagogastric junction

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  • 维普
  • 万方数据
目的 比较全腹腔镜下食管-空肠π式吻合与腹腔镜辅助食管-空肠Roux-en-Y吻合在贲门癌全胃切除术的近期临床疗效及安全性.方法 分析2020年6月—2022年7月在蚌埠医科大学第一附属医院治疗的72例食管胃结合部腺癌患者的临床及病理资料.所有患者均行腹腔镜全胃切除+D2淋巴结清扫术,其中38例患者行全腹腔镜下贲门癌根治术+食管-空肠π吻合(全腹腔镜组),34例患者采用腹腔镜辅助贲门癌根治术+食管-空肠Roux-en-Y吻合(腹腔镜辅助组),分析不同术式的安全性及对应激反应的影响.结果 全腹腔镜组手术时间长于腹腔镜辅助组且手术切口长度显著短于腹腔镜辅助组(P＜0.001).全腹腔镜组术中出血量[(130.26±23.54)mL]明显低于腹腔镜组[(167.21±28.53)mL,t=6.017,P＜0.001].全腹腔镜组术后首次排气时间明显短于腹腔镜辅助组(P=0.003).2组术后拔除引流管时间、术后住院时间、术后并发症发生情况及手术清扫淋巴结个数比较,差异均无统计学意义(P＞0.05).术后第1天和第5天全腹腔镜组患者血清CRP水平显著低于腹腔镜辅助组(P＜0.05).结论 全腹腔镜下贲门癌根治+食管-空肠π吻合的手术方式是安全的,能够减少术中出血,缩短患者恢复时间,缓解术后疼痛,减少术后并发症的发生,且对机体创伤性应激反应的影响较小.
Objective To analyze the short-term clinical efficacy and safety of total laparoscopic π-shaped esophageal jeju-nostomy and laparoscopic assisted Roux-en-Y esophago-jejunostomy for adenocarcinoma of the esophagogastric junction.Methods The clinical and pathological data of 72 patients with adenocarcinoma of the esophagogastric junction treated in the First Affiliated Hospital of Bengbu Medical University from June 2020 to July 2022 were collected.All patients under-went laparoscopic total gastrectomy+D2 lymphadenectomy,in whom 38 patients underwent total laparoscopic radical resec-tion of cardiac cancer+π-shaped esophageal jejunostomy and 34 patients underwent laparoscopic-assisted radical resection of cardiac cancer+Roux-en-Y esophago-jejunostomy.The safety and effects on stress response indicators of different surgi-cal methods were analyzed.Results The mean operation time of the total endoscopy group was longer than that of the lapa-roscopic-assisted group and the length of the incision was significantly shorter than that in the laparoscopic-assisted group(P＜0.001).In terms of intraoperative bleeding,the amount of intraoperative bleeding in the total endoscopy group(130.26±23.54)mL was significantly lower than that in the laparoscopic group[(167.21±28.53)mL,t=6.017,P＜0.001].The first postoperative exhaust time in the total endoscopy group was significantly lower than that in the laparo-scopic-assisted group(P=0.003).There were no significant differences in extubation time,postoperative hospitalization days,postoperative complications,and number of surgically removed lymph nodes between the two groups(P＞0.05).The serum level of CRP in the total endoscopy group was significantly lower than that in the laparoscopic-assisted group on the first and fifth day after surgery(P＜0.05).Conclusion Total laparoscopic radical resection of cardiac cancer+π esoph-agojejunostomy is safe,which can reduce intraoperative bleeding,shorten the recovery time of patients,relieve postopera-tive pain,greatly reduce the occurrence of postoperative complications,and has little effect on the body's traumatic stress response.

Adenocarcinoma of esophagogastric junctionTotal laparoscopic surgeryTotal gastrectomyπ-shaped esoph-agojejunalTraumatic stress

张晨嵩、潘成武、王庆康、王远鹏、吴晗、马家驰

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蚌埠医科大学第一附属医院肿瘤外科,安徽蚌埠 233004

蚌埠医科大学第二附属医院普通外科,安徽蚌埠 233000

贲门癌 完全腹腔镜 全胃切除术 π吻合 创伤应激

安徽省自然科学基金面上项目安徽省高等学校自然科学研究重点项目蚌埠市科学技术指导类项目蚌埠医学院第一附属医院高新技术领先项目

2208085MH2422023AH051990202201302023032

2024

10.16766/j.cnki.issn.1674-4152.003543

中华全科医学
中华预防医学会,安徽省全科医学会

中华全科医学

CSTPCD
影响因子：1.688
ISSN：1674-4152
年,卷(期)：2024.22(6)