腹腔镜全胃切除术后不同消化道重建方式对胃癌患者的临床疗效研究

目的探讨腹腔镜全胃切除术后不同消化道重建方式对胃癌患者的临床疗效。 方法回顾性分析2016年1月至2019年1月86例行腹腔镜全胃切除的胃癌患者资料，根据消化道重建方式不同，分为研究组和对照组各43例，对照组采用传统Roux－en－Y吻合术重建消化道，研究组采用双通道空肠间置消化道重建。数据采用SPSS17.0进行分析，并发症等计数资料行χ²检验；围手术指标、血液营养指标等计量资料采用( ±s)表示，独立t检验，P<0.05差异有统计学意义。 结果两组首次进食时间、消化道重建时间、首次排气时间、手术出血量和住院时间差异无统计学意义(P>0.05)；研究组与对照组比较，围术期并发症(9.8%比27.5%)和术后并发症(21.9%比47.5%)，研究组均低于对照组(P<0.05)；研究组营养指标及体质量的变化优于对照组(P<0.05)。 结论胃癌全胃切除术患者采用双通道空肠间置消化道重建，可降低并发症发生率，改善患者预后。

Clinical effect of different reconstruction methods of digestive tract after laparoscopic total gastrectomy on patients with gastric cancer

ObjectiveTo investigate the clinical efficacy of different digestive tract reconstruction methods in patients with gastric cancer after laparoscopic total gastrectomy. MethodsThe data of patients with gastric cancer treated with laparoscopic total gastrectomy from January 2016 to January 2019 were retrospectively analyzed. According to the different ways of digestive tract reconstruction, 43 cases were divided into study group and control group. In the control group, traditional Roux-en-Y anastomosis was used to reconstruct the digestive tract. In the study group, the double-channel jejunal digestive tract reconstruction was used. SPSS17.0 was used to analyze the data, and χ² test was performed on the counting data of complications. The perioperative index, blood nutrition index and other measurement data were expressed by ( ±s), and compared with independent t test. P<0.05 showed statistically significant differences. ResultsThere was no significant difference between the two groups in the time of the first feeding, the time of digestive tract reconstruction, the time of the first exhaust, the amount of blood loss and the length of hospital stay (P>0.05). Compared with the control group, the perioperative complications (9.8% vs. 27.5%) and postoperative complications (21.9% vs. 47.5%) were lower in the study group than in the control group (P<0.05). The changes of nutrition indexes and body mass in the study group were better than those in the control group (P<0.05). ConclusionFor patients with gastric cancer with total gastrectomy, double-channel jejunal digestive tract reconstruction can reduce the incidence of complications, improve the safety of treatment and improve the prognosis of patients.