Effects of double tract reconstruction on nutritional status and complica-tions in patients undergoing laparoscopic proximal gastrectomy
Objective To investigate the effects of double tract reconstruction(DTR)on nutritional status and complications in patients undergoing laparoscopic proximal gastrectomy(LPG).Methods Sixty-four patients with proximal gastric cancer admitted to Lishui Central Hospital,Zhejiang Province from January 2021 to December 2022 were selected and divided into control group(32 cases)and experimental group(32 cases)according to operative methods.The control group underwent laparoscopic total gastrectomy and reconstruction with Roux-en-Y jejunoesophagus anastomosis with digestive tract reconstruction,and the experimental group underwent LPG+DTR.Perioperative period indexes(operation time,intraoperative bleeding volume[IBV],first postoperative anal exhaust time,first feeding time,postoperative visual analogue scale[VAS]score,lower esophageal sphincter pressure[LESP])were evaluated in both groups.The levels of gastrointestinal hormones(motilin[MTL],somatostatin[SST],vasoactive in-testinal peptide[VIP])before and three days after operation were compared between the two groups.Nutritional indexes(hemoglobin[Hb],serum albumin[Alb],and body mass index[BMI])of the two groups were compared before and three months after operation,and postoperative complica-tions were observed.Results The operation time and first feeding time of experimental group were longer than those of control group,the first post-operative anal exhaust time was shorter than that of control group,the IBV and VAS were lower than those of control group,and the LESP was high-er than that of control group(P＜0.05).At three days after surgery,MTL and SST in both groups were lower than those before operation,VIP was higher than that before operation,and MTL and SST in experimental group were higher than those of control group,VIP was lower than that of con-trol group(P＜0.05).Three months after operation,Hb and Alb of the two groups were lower than those before operation,BMI of the control group was lower than that before operation,BMI of the experimental group was higher than that before operation,and Hb,Alb,BMI of the experimental group were higher than those of the control group(P＜0.05).The total incidence of postoperative complications in experimental group was lower than that in control group(P＜0.05).Conclusion DTR combined with LPG can improve nutritional status,regulate gastrointestinal hormone levels,and reduce complications in patients with proximal gastric cancer.
万方数据
维普
