腹腔镜下胃空肠吻合联合Braun吻合在胃癌并幽门梗阻患者中的应用效果

Efficacy of Gastrojejunostomy Combined with Braun's Anastomosis under Laparoscope in Treatment of Gastric Cancer Patients with Pyloric Obstruction

目的探讨腹腔镜下胃空肠吻合联合Braun吻合在胃癌并幽门梗阻患者中的应用效果。方法选择2009年12月—2014年12月收治胃癌并幽门梗阻107例,按治疗方法分为观察组42例和对照组65例。观察组行腹腔镜下胃空肠吻合术联合Braun吻合术,对照组行腹腔镜下胃空肠吻合术。观察两组手术及术后恢复情况。结果观察组胃管留置时间和住院时间均短于对照组,吻合口炎和吻合口梗阻发生率低于对照组,保守治疗时间短于对照组(P<0.05)。观察组术后3个月白蛋白和总蛋白高于对照组(P<0.05)。结论腹腔镜下胃空肠吻合联合Braun吻合对晚期胃癌并幽门梗阻无法切除患者的治疗安全可行,可以明显降低术后患者吻合口狭窄的发生,解决患者无法进食症状,改善患者生活质量。

Objective To investigate the effect of gastrojejunostomy combined with Braun＇s anastomosis under laparoscope in treatment of gastric cancer patients with pyloric obstruction. Methods A total of 107 gastric cancer patients with pyloric obstruction from December 2009 to December 2014 were divided into observational group（ n = 42） and control group（ n = 65）. The observational group received gastrojejunostomy combined with Braun ＇s anastomosis under laparoscope,while the control group received gastrojejunostomy under laparoscope. The indexes of postoperative recovery in the two groups were compared. Results In the observational group,the time of stomach tube retention and hospital stay were shortened,and the incidence rates of inflammations and obstruction in anastomotic stoma were significantly lower,the time of expectant treatment was shorter than those in control group（ P 0. 05）. Levels of albumin and total protein in postoperative 3 months in the observational group were higher than those in the control group（ P 0. 05）. Conclusion The gastrojejunostomy combined with Braun＇s anastomosis under laparoscope in treatment of gastric cancer patients with pyloric obstruction,who are impossible to cut tumors,is safe and feasible,and it can reduce the incidence rate of anastomotic stenosis,solve the symptom of difficult eating and improve the quality of life.