胃三角吻合术与Billroth I吻合术在腹腔镜远端胃癌根治术中的短期疗效比较

目的：比较胃三角吻合术与Billroth I吻合术在腹腔镜远端胃癌根治术中短期疗效。 方法：选取解放军总医院2009—2013年间37例行腹腔镜远端胃癌根治术的早期胃癌患者资料，其中14例行胃三角吻合术（三角吻合组），23例行Billroth I吻合术（Billroth I吻合组），比较两组术中及术后的相关指标。 结果：与Billroth I吻合组比较，三角吻合组手术时间延长，但术中出血量降低，止痛泵使用时间、术后排气时间、拆线时间均缩短，差异均有统计学意义（均P<0.05）；两组住院时间方面差异无统计学意义（P>0.05）。术后病理显示，三角吻合组近、远端切缘距肿瘤的平均距离均明显大于Billroth I吻合组（均P<0.05）。两组术后并发症与不良反应发生率差异无统计学意义（P>0.05）。 结论：三角吻合能一定程度减少腹腔镜远端胃癌根治术患者的创伤、疼痛，降低腔镜下操作难度及感染的风险，加速患者胃肠道功能恢复。

Delta-shaped anastomosis versus Billroth I anastomosis in laparoscopic radical resection of distal gastric cancer: short-term efficacy analysis

Objective: To compare the short-term efficacy of the delta-shaped anastomosis and Billroth I anastomosis in laparoscopic radical distal gastrectomy. Methods: The records of 37 patients with early-stage gastric cancer undergoing laparosicopic radical distal gastrectomy in PLA General Hospital between 2009 and 2013 were selected. Of the patients, 14 cases received delta-shaped anastomosis (delta-shaped anastomosis group) and 23 cases were subjected to Billroth I anastomosis (Billroth I anastomosis group), and the relevant intraoperative and postoperative parameters between the two groups were compared. Results: In delta-shaped anastomosis group compared with Billroth I anastomosis group, the operative time was prolonged, but the intraoperative blood loss was reduced, duration of the analgesic pump therapy, and time to first flatus and suture removal were all shortened, and all the differences had statistical significance (all P<0.05); there was no statistical difference in length of hospital stay between the two groups (P>0.05). Postoperative pathology showed that the distance of the proximal and distal surgical margins from the tumor in delta-shaped anastomosis group was significantly longer than those in Billroth I anastomosis group (both P<0.05). No statistical difference was noted in incidence of postoperative complications and adverse reactions between the two groups (P>0.05). Conclusion: The delta-shaped anastomosis can, to a certain degree, reduce the trauma and pain in patients undergoing laparoscopic radical distal gastrectomy, decrease the operative difficulty of laparoscopic surgery and the risk of infection, and promote the recovery of gastrointestinal function of the patients.