腹腔镜胃癌根治术后胃瘫综合征的诊治策略

目的:探讨腹腔镜胃癌根治术患者术后胃瘫综合征的发生率及诊治策略，提高其诊治水平。方法:回顾性分析2007年7月至2015年7月1 861例腹腔镜胃癌根治术与同期1 953例开腹胃癌根治术患者的临床资料，研究两组患者术后胃瘫综合征的发生率及诊治策略。结果:腹腔镜胃癌根治术患者术后胃瘫综合征发生率为1.56%，开腹胃癌根治术患者术后胃瘫综合征发生率为6.35%，差异具有统计学意义（P＜0.05）。所有患者均经保守治疗而获治愈。出院后随访半年无复发。结论:腹腔镜胃癌根治术患者术后胃瘫综合征发生率低于开腹手术。术后胃瘫综合征发生后进行准确的诊断、心理疏导、持续胃肠减压、营养支持、维持内环境稳定、必要的药物治疗及胃镜治疗是术后胃瘫综合征治疗的有效方法。

Study on the diagnosis and treatment of postoperative gastroparesis syndrome in patients underwent laparoscopic radical gastrectomy

Objective:To explore the incidence rate and strategy of diagnosis and treatment of postoperative gastroparesis syndrome in patients underwent laparoscopic radical gastrectomy,and to improve the level of diagnosis and treatment.Methods:The clinical data were retrospectively analyzed in 1861 patients underwent laparoscopic radical gastrectomy and 1953 patients underwent open radical gastrectomy over the same period from July 2007 to July 2015 in our hospital.To study the incidence rate and strategy of diagnosis and treatment of postoperative gastroparesis syndrome in the two groups.Results:The incidence of postoperative gastroparesis syndrome was 1.56% in laparoscopic radical gastrectomy,and the incidence of postoperative gastroparesis syndrome was 6.35% in open radical gastrectomy,the difference was statistically significant(P＜0.05).All patients were cured by conservative treatment.All patients were followed up for half a year after discharge from hospital,and there was no recurrence.Conclusion:The incidence of postoperative gastroparesis syndrome in laparoscopic radical gastrectomy is lower than that of open radical gastrectomy.The accurate diagnosis of postoperative gastroparesis syndrome is the premise,psychological guidance,continuous gastrointestinal decompression,nutritional support,maintenance of the stability of the internal environment,necessary medical treatment and endoscopic treatment are effective methods for treatment of postoperative gastroparesis syndrome.