腹腔镜胃癌全胃切除术后两种消化道重建方式的疗效比较

Efficacy Comparison of Two Digestive Tract Reconstruction Methods after Laparoscopic Total Gastrectomy of Gastric Cancer

目的比较功能性空肠间置代胃重建术(FJI)和P型Roux-en-Y全胃切除空肠代胃术(PR)两种不同消化道重建方式对胃癌患者临床疗效分析。方法纳入实施全胃切除的76例胃癌患者,34例行FJI重建术(n=34),42例行PR重建术(n=42),观察两组患者术后消化道并发症发生率及营养指标。结果 76例患者均随访6个月,FJI重建组手术时间为(82±22)min,PR重建组手术时间为(81±21)min,无显著差异(P>0.05);FJI重建组术中出血量为(270±150)m L,PR重建组术中出血量为(243±135)m L,差异显著(P<0.05);PR重建组并发生发生率(14.3%)显著高于FJI重建组(5.9%);但两组营养指标(体质量、血红蛋白、白蛋白、总蛋白)比较,差异无显著性意义(P>0.05)。结论 FJI和PR消化道重建术均安全可行,PR消化道重建出血量少于FJI,但近期随访FJI组并发症的发生率低于PR组。

Objective To investigate the efficacy of two digestive tract reconstruction methods after laparoscopic total gastrectomy of gastric cancer. Methods 76 cases with total gastrectomy for gastric cancer, 34 cases FJI reconstruction （ n = 34）, 42 PR routine revascularization （ n = 42）, Postoperative gastrointestinal complications and nutrition indicators groups of patients. Results 76 patients were followed up for 6 months, FJI group operation time was （82 ± 22） rain, PR group operating time for min （81 ± 21 ）, there was no significant difference （P 〉 0. 05 ） ; FJI group intraoperatie blood loss （270 ± 150）mL, PR bleeding amount of reconstruction group for mL （243 ± 135）, there was the significant difference （ P 〈 0. 05 ） ; PR reconstruction group had a significantly higher incidence （ 14. 3% ） than FJI group （5. 9% ） ; But two groups of nutrition indicators （body mass, hemoglobin, albumin, total protein）, there was no signifi- cant difference （P 〉 0. 05）. Conclusions FJI and PR digestive tract reconstruction are safe and feasible, PR gastroin- testinal bleeding rebuilt less than FJI, but the recent follow - FJI group incidence of complications is less than PR group.