腹腔镜辅助远端胃切除术重建方式的比较

Comparison of reconstruction methods after laparoscopy-assisted distal gastrectomy

目的:比较早期胃癌患者接受腹腔镜辅助远端胃切除术(LADG)后行Roux-en Y(RY)重建与Billroth Ⅰ(B Ⅰ)重建的短期结果。方法:2002年6月～2007年2月共有96例早期胃癌患者在日本大分大学医院接受了LADG,其中RY重建22例、BⅠ重建74例。比较RY组和BⅠ组患者的临床病理特点、术中情况、并发症、术后经过和血化验结果。结果:2组间术中情况、总并发症率、术后经过和血清学检查结果均无显著性差异(均P>0.05)。2组间手术相关并发症和一般并发症的发生率也无显著性差异(均P>0.05)。RY组有1例吻合口漏和2例胃排空障碍;而BⅠ组有2例吻合口狭窄。结论:LADG术后采用RY重建是安全可行的,具有和BⅠ重建同样的腹腔镜微创手术的优点。

Objective：To compare the safety and feasibility of Roux-en Y（RY） reconstruction with Billroth I（B Ⅰ） reconstruction after laparoscopy-assisted distal gastrectomy（LADG）.Methods：Twenty-two patients underwent LADG with RY reconstruction,and 74 patients underwent LADG with BⅠ reconstruction at the Department of Surgery I,Oita University Hospital during June 2002 to February 2007.Clinico-pathological data,surgical findings,complications,postoperative course and results of blood tests were compared between the RY group and the B Ⅰ group.Results：Surgical findings,overall complication rate,postoperative course,and blood test results did not have any significant differences between the two groups.Incidences of surgery-related and general complications were also no difference between the two groups.In the RY group,one case of anastomotic leakage and two cases of gastric stasis were observed.In the BⅠ group,two cases of anastomotic stenosis were observed.Conclusion：LADG with RY is safe and has the same advantages of laparoscopic surgery as the one with BⅠ reconstruction.