摘要
目的:分析将食物袢固定于十二指肠残端以预防Petersen疝、Roux-en-Y滞留综合征发生的临床效果。方法:回顾分析2012年2月至2020年2月为254例患者行Roux-en-Y重建的根治性远端胃切除术的临床资料。对比Roux-en-Y重建后将食物袢固定于十二指肠残端(固定组,n=95)与未固定(未固定组,n=159)Petersen疝、Roux-en-Y滞留综合征的发生率。结果:未固定组中7例(4.4%)发生Petersen疝,24例(15.1%)出现Roux-en-Y滞留综合征;固定组无一例发生Petersen疝(P=0.038),2例发生Roux-en-Y滞留综合征(P=0.001)。未固定组内,腹腔镜亚组的39例患者中3例发生Petersen疝;固定组内,腹腔镜亚组的50例患者均未发生Petersen疝;腹腔镜亚组内,固定亚组Petersen疝(P=0.047)、Roux-en-Y滞留综合征(P=0.004)的发生率低于未固定亚组。结论:Roux-en-Y重建后,将食物袢固定于十二指肠残端可有效减少Petersen疝、Roux-en-Y滞留综合征的发生。
Objective:To analyze the clinical effect of fixation of Roux limb and duodenal stump to prevent the occurrence of Petersen’s hernia and Roux-en-Y stasis syndrome.Methods:This study retrospectively analyzed 254 consecutive patients between Feb.2012 and Feb.2020 who underwent radical distal gastrectomy for gastric cancer,with antecolic Roux-en-Y reconstruction.The incidence of Petersen’s hernia and Roux-en-Y stasis syndrome after Roux-en-Y reconstruction was compared between the fixed group(fixing the Roux limb to the duodenal stump,n=95)and unfixed group(n=159).Results:In unfixed group,Petersen’s hernia occurred in 7 p atients(4.4%)and Roux-en-Y stasis syndrome occurred in 24(15.1%)after surgery;while in fixed group,Petersen’s hernia did not occur(P=0.038)and only 2 patients suffered from Roux-en-Y stasis syndrome(P=0.001).Focusing on the laparoscopic procedure,in unfixed group Petersen’s hernia occurred in 3 of 39 patients,whereas in fixed subgroup(n=50)Petersen’s hernia did not o ccur.In the laparoscopic subgroup,the incidence of Petersen’s hernia(P=0.047)and Roux-en-Y stasis syndrome(P=0.004)in fixed subgroup was lower than that in unfixed subgroup.Conclusions:Fixation of Roux limb and duodenal stump is an effective method to decrease the incidence of Petersen’s hernia and Roux-en-Y stasis syndrome after distal gastrectomy and Roux-en-Y reconstruction.
作者
吴建忠
沈根海
郎建华
黄维贤
WU Jian-zhong;SHEN Gen-hai;LANG Jian-hua(Department of Gastroenterology Surgery,Suzhou Ninth People’s Hospital,Soochow University,Suzhou 215200,China)
出处
《腹腔镜外科杂志》
2023年第4期262-265,280,共5页
Journal of Laparoscopic Surgery
