摘要
目的探讨腹腔镜辅助双通道消化道重建技术在近端胃切除术中的临床疗效。方法前瞻性纳人2018年1月1日至2020年12月31日收治的胃上部癌患者60例,采用随机数字表法将患者分为A、B、C三组,每组20例。A组患者行腹腔镜辅助近端胃切除食管胃吻合术,B组患者行腹腔镜辅助全胃切除Roux-en-Y吻合术,C组患者行腹腔镜辅助近端胃双通道吻合术。数据应用软件SPSS 22.0进行分析,围手术期相关指标等计量资料采用(x±s)表示,多组间比较行单因素方差分析,两组间比较行LSZM检验,组内比较行配对样本f检验,术后并发症等计数资料行Y检验。P<0.05表示差异有统计学意义。结果三组患者手术时间:C组长于A组、B组(P<0.05);三组患者术后反流性食管炎发生率:C组明显低于A组、B组(P<0.05);三组患者术后6个月血清血红蛋白(Hb)、总蛋白(TP)、白蛋白(ALB)、前白蛋白(PAB)等营养指标较术前均显著降低(P<0.05),但C组各营养指标均明显高于A组、B组(P<0.05);三组患者术后6个月生活质量量表(SF-36)各项评分C组显著高于A组、B组(P<0.05)。结论腹腔镜辅助双通道消化道重建技术在近端胃切除术中安全可行,具有显著的抗反流效果,有利于患者术后营养恢复及生活质量的改善。
Objective To investigate the clinical effect of laparoscopic assisted double channel reconstruction of digestive tract in proximal gastrectomy.Methods 60 patients with upper gastric cancer treated from January 1,2018 to December 31,2020 were prospectively enrolled.They were randomly divided into group A,group B and group C by random number method,with 20 patients in each group.Patients in group A received laparoscopic assisted proximal gastrectomy and esophagogastrostomy,group B received laparoscopic assisted total gastric resection Roux-en-Y anastomosis,group C received laparoscopic assisted proximal stomach anastomosis of dual channel.SPSS 22.0 was used for statistical analysis.The measurement data of perioperative related indexes were expressed by(x±s).One-way AN OVA was performed for comparison between multiple groups,LSD-t test was performed for comparison between two groups,paired sample t test was performed for intra-group comparison,and statistical data such as postoperative complications were performed by (x±s) test.P<0.05 indicated statistically significant difference.Results The operation time of group C was longer than that of group A and group B(P<0.05);The incidence of postoperative reflux esophagitis in group C was significantly lower than that in group A and group B(P<0.05).6 months after operation,serum hemoglobin(Hb),total protein(TP),albumin(ALB)and prealbumin(PA)in the three groups were significantly lower than those before operation(P<0.05).The nutritional indexes in group C were significantly higher than those in group A and group B(P<0.05).SF-36 scores in group C were significantly higher than those in group A and group B at 6 months after surgery(P<0.05).Conclusion Laparoscope-assisted dual-channel gastrointestinal reconstruction technique is safe and feasible in proximal gastrectomy,with significant anti-reflux effect,which is conducive to postoperative nutritional recovery and improvement of quality of life of patients.
作者
张吴楼
郑立锋
刘宏达
Zhang Wulou;Zheng Lifeng;Liu Hongda(Department two of General Surgery,Jiangbei Hospital,Nanjing Jiangsu Province 210048,China;Department of Gastric Surgery,Jiangsu Provincial People’s Hospital,Nanjing Jiangsu Province 210029,China)
出处
《中华普外科手术学杂志（电子版）》
2022年第3期263-266,共4页
Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)
基金
2020年度江苏省博士后科研资助计划(2020Z069)
中国博士后科学基金第67批面上资助(2020M671392)。
关键词
腹腔镜
胃切除术
消化道重建
双通道
疗效比较研究
Laparoscopes
Gastrectomy
Digestive tract reconstruction
Double channel
Comparative effectiveness research
