逆蠕动非离断Roux-en-Y吻合在腹腔镜远端胃癌根治术中的应用
Application of antiperistaltic uncut Roux-en-Y anastomosis in laparoscopic distal gastrectomy for gastric cancer
柯彬 1金鹏 1刘洪敏 1王学军 1刘宁 1梁寒 1张汝鹏1
作者信息
- 1. 天津医科大学肿瘤医院胃部肿瘤科国家恶性肿瘤临床医学研究中心天津市恶性肿瘤临床医学研究中心天津市消化系统肿瘤重点实验室,天津 300060
- 折叠
摘要
目的 探讨逆蠕动非离断Roux-en-Y吻合(Uncut RY)在腹腔镜远端切除术后消化道重建中的效果.方法 收集2020年1月至2021年12月间天津医科大学肿瘤医院收治的309例行腹腔镜远端胃癌根治术患者的临床病理资料,根据重建方式不同将患者分为Uncut RY组(102例)、RY组(96例)、B Ⅱ+Braun组(111例),比较3组的手术安全性和近期、远期疗效.结果 UncutRY组和B Ⅱ+Braun组的手术时间较RY组明显缩短,差异有统计学意义(F=3.356,P=0.036).3组患者的短期并发症差异无统计学意义(P＞0.05).B Ⅱ+Braun组反流性胃炎发生率高于Uncut RY组和RY组,差异有统计学意义(19.8％比6.9％比5.2％,F=13.889,P=0.001).而RY组潴留综合征发生率高于Uncut RY组和B Ⅱ+Braun组,差异有统计学意义(15.6％比2.0％比2.7％,F=19.320,P=0.000).3组患者术后1年的营养学变化率差异无统计学意义(P＞0.05).结论 腹腔镜远端胃癌根治术中采用逆蠕动Uncut RY吻合安全可靠,能降低反流性胃炎及潴留综合征等并发症的发生率.
Abstract
Objective To investigate the clinical efficacy of antiperistaltic uncut Roux-en-Y anastomosis(Uncut RY)in laparoscopic distal gastrectomy(LDG)for gastric cancer(GC).Methods The clinicpathological data of 309 patients who underwent LDG for GC between Jan 2020 to Dec 2021 in Tianjin Medical University Cancer Institute & Hospital were collected.Among them,102 cases received antiperistaltic Uncut RY anastomosis,96 cases did RY anastomosis,and 111 cases did B Ⅱ+Braun anastomosis.The general data and clinical efficacy were compared.Results The operative time in Uncut RY group and B Ⅱ+Braun group was shorter than that in RY group(F=3.356,P=0.036).The incidence of postoperative short-term complications was not statistically different among three groups(P＞0.05).Compared to Uncut RY group and RY group,the B Ⅱ+Braun group had a significantly higher incidences of reflux gastritis(19.8％vs.6.9％vs.5.2％,F=13.889,P=0.001).The incidence of RY stasis syndrome in RY group(15.6％)was significantly higher than that in Uncut RY group(2.0％)and B Ⅱ+Braun group(2.7％)(F=19.320,P=0.000).There were no significant differences in postoperative 1-year nutritional indexes among three group(P＞0.05).Conclusions The antiperistaltic Uncut RY anastomosis in LDG for GC is safe and feasible,which can reduce the incidences of reflux gastritis and RY stasis syndrome.
关键词
胃肿瘤/吻合术,Roux-en-Y/蠕动/胃切除术/腹腔镜Key words
Stomach neoplasms/Anastomosis,Roux-en-Y/Peristalsis/Gastrectomy/Laparoscopy引用本文复制引用
基金项目
国家自然科学基金(81401952)
天津市卫生局科技基金(2014KZ082)
天津市医学重点学科(专科)建设项目(TJYXZDXK-009A)
出版年
2024
NETL
NSTL
万方数据