完全腹腔镜下远端胃癌根治术后消化道重建的疗效观察

目的胃空肠非离断式Roux-en-Y吻合术对完全腹腔镜下远端胃癌根治术后消化道重建的疗效观察。方法选取2011年1月至2015年10月期间接受治疗的82例胃癌患者,按照完全腹腔镜下远端胃癌根治术后消化道重建方式的不同分为治疗组(胃空肠非离断式Roux-en-Y吻合术组,41例)和对照组(Orr式空肠食管Roux-en-Y吻合术组,41例),数据经过SPSS19.0进行处理,消化道重建的时间等计量资料用(x珋±s)表示,组间比较采用t检验;肿瘤类型、并发症发生率、术后1年电子胃镜检查结果均采用%的方式表示,组间比较采用χ~2检验,检验水准α=0.05,所有的统计分析均采用双侧检验。结果治疗组消化道重建时间(36.9±4.8)min显著性低于对照组消化道重建时间(45.1±5.3)min](P0.05);治疗组患者术后消化道重建相关并发症总发生率(2.4%)显著性低于对照组(34.1%)(χ~2=6.332,P0.05);治疗组患者术后1年胃炎以及反流性食管炎的发生率(2.4%,2.4%)均显著低于对照组(12.2%,17.1%)(P0.05)。结论胃空肠非离断式Roux-en-Y术对完全腹腔镜下远端胃癌根治术后消化道重建的疗效显著,并发症发生率低,能有效的预防胃炎及反流性食管炎的发生,提高患者的生活质量,值得临床进一步推广使用。

Clinical observation of digestive tract reconstruction after total gastrectomy for distal gastric cancer

Objective To investigate the clinical efficacy of Gastrojejunostomy Uncut Roux-en-Y reconstruction in Digestive tract reconstruction after distal gastrectomy for gastric caner.Methods 82 patients with gastric caner were treated in our hospital from January 2011 to October 2015.The patients were randomly divided into observation group and control group according to the different digestive tract reconstruction methods,with 41 cases in each group.Patients in control group received Orr formula esophagus jejunum Roux-en-Y reconstruction,while patients in observation group underwent gastrojejunostomy uncut Roux-en-Y reconstruction.Statistical analysis were performed by using SPSS 19.0 statistical software.The measurement data such as Operation time of digestive tract reconstruction were expressed as mean ± standard deviation (x ± s),and were examined by using t test.Count data were examined by using x2 test,includin constitution of tumors (％),complication rate (％) and results of electronic gastroscopy post operation 1 year.A P value ＜ 0.05 was considered as statistically significant difference.Results Compared with control group,there were shorter operation time of digestive tract reconstruction time (36.9 ± 4.8) min vs (45.1 ± 5.3) min],lower complication rate (2.4％ vs 34.1％)and lower incidence of postoperative gastritis and reflux esophagitis after 1-year (2.4％ and 2.4％ vs 12.2％ and 17.1％ respectively) in the observation group,with significant difference (P ＜ 0.05).Conclusion The Gastrojejunostomy Uncut Roux-en-Y reconstruction could improve curative efficacy,reduce morbidity and could effectively prevent gastritis and reflux esophagitis with improved the quality of life,which is worth of further clinical promotion.