摘要
目的探讨早期近端胃癌行近端胃根治术后不同消化道重建方式的手术安全性、术后并发症的临床数据,为近端胃切除消化道重建方式的最佳选择提供临床依据。方法回顾性分析在2013年1月至2016年6月92例早期近端胃癌行近端胃切除患者的临床资料。其中:45例行传统食管残胃吻合术(EG组);20例行单通道空肠间置术(JI组);27例行双通道空肠间置术(DTR组)。采用SPSS 21.0统计软件包进行分析,围手术期指标以均数±标准差表示,两样本间的比较连续资料符合正态分布采用t检验,三组间的计量资料比较采用单因素方差分析;术后并发症比较采用χ2检验。P<0.05为差异具有统计学意义。结果 EG组较JI组及DTR组手术时间更短,但在术中出血量、术后排气及住院时间上差异无统计学意义。三组在术后总并发症对比上差异有统计学意义(P<0.05),特别是反流性食管炎发生率比较中,JI组、DTR组均比EG组低,差异有统计学意义(P<0.05),而JI组与DTR组比较无显著差异。结论早期近端胃癌采用空肠间置吻合术手术相对安全,近端胃切除后残胃食管吻合的反流性食管炎发生率较高,空肠间置术能够明显降低近端胃切除后食管反流发生,是早期近端胃癌根治术后较合理的消化道重建方法。
Objective To compare the surgical safety, postoperative complications of patients with early proximal gastric cancer of different methods of reconstruction, and choose the best methods of digestive track reconstruction. Methods Clinical data of 92 patients with early proximal gastric cancer treated in our hospital from January, 2013 to June, 2016 was retrospectively analyzed. They were divided into 3 groups according to the different digestive tract reconstruction, 45 esophagogastrostomy（EG group）, 20 Single-canal jejunum interposition（JI group） and 27 double tract reconstruction（DTR group）. The data was analyzed using SPSS21.0 statistical software. Perioperative indicators were showed by （ x±s） , and compared with t test, the measurement data was compared using single factor analysis of variance between the three groups; Postoperative complications were compared using the χ 2 test. P 〈0.05 was statistically significant . Results Compared with JI group and DTR group, EG group had shorter operation time, but there was no significant difference in intraoperative blood loss, postoperative hospital stay, ventilation time in the three groups. The differences in total postoperative complications were statistically significant （ P〈0.05） . Especially, the incidence of reflux esophagitis was significantly higher in the EG group than in the JI or DRT group （ P〈0.05）. But no significant difference between JI group and the DTR group were found. Conclusion Patients underwent proximal gastrectomy followed with conventional EG has higher rate of reflux esophagitis. JI and DTR may be the reasonable choice of digestive tract reconstruction after radical resection of early proximal gastric cancer.
作者
王伟
马从超
汤东
熊清泉
金芝祥
孟庆洋
王道荣
WangWei;Ma Congchao;Tang Dong;Xiong Qingquan;Jin Zhixiang;Meng Qingyang;Wang Daorong(Department of Gastrointestinal Surgery,Northern Jiangsu People＇s Hospital,225001)
出处
《中华普外科手术学杂志（电子版）》
2018年第5期414-417,共4页
Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)
