三角吻合术在腹腔镜远端胃癌根治术后消化道重建中的应用效果

Application effect of triangle anastomosis in digestive tract reconstruction after laparoscopic distal radical gastrectomy of gastric cancer

目的探讨分析三角吻合术在全腹腔镜远端胃癌根治术中的临床效果。方法 69例远端胃癌患者,按手术方式不同将其分为对照组(34例)和实验组(35例)。对照组患者采取常规腹腔镜辅助下远端胃癌根治术,实验组患者采取全腹腔镜下远端胃癌根治术+三角吻合术。比较两组术中情况、术后恢复情况以及与吻合口相关并发症发生情况。结果两组手术时间、淋巴结清扫个数比较差异均无统计学意义(P>0.05);实验组术中出血量(54.84±2.93)ml、术后胃肠功能恢复时间(1.95±0.68)d、镇痛剂使用量(1.58±0.37)支、住院时间(8.73±1.43)d,均明显少于对照组的(90.38±2.08)ml、(3.71±0.49)d、(3.62±1.06)支、(13.04±1.15)d,差异均具有统计学意义(P<0.05)。实验组并发症发生率为0,低于对照组的11.76%,差异具有统计学意义(P<0.05)。结论三角吻合术应用于全腹腔镜远端胃癌根治术中效果显著,安全性高,是一种较为理想的消化道重建术式。

Objective To explore and analyze the clinical effect of triangle anastomosis in digestive tract reconstruction after laparoscopic distal radical gastrectomy of gastric cancer.Methods A total of69distal gastric cancer patients were divided by different operation methods into control group(34cases)and experimental group(35cases).The control group received conventional laparoscopic assisted distal radical gastrectomy of gastric cancer,and the experimental group received total laparoscopic distal radical gastrectomy of gastric cancer+triangle anastomosis.Comparison were made on intraoperative situation,postoperative recovery and complications associated with anastomotic in two groups.Results Both groups had no statistically significant differencein operation time and number of lymph node cleaning(P>0.05).The experimental group had intraoperative bleeding volume as(54.84±2.93)ml,postoperative gastrointestinal function recovery time as(1.95±0.68)d,analgesic dosage as(1.58±0.37)pieces,and hospital stay time as(8.73±1.43)d,which were all clearly less than(90.38±2.08)ml,(3.71±0.49)d,(3.62±1.06)pieces and(13.04±1.15)d in the control group,and their difference had statistical significance(P<0.05).The experimental group had lower incidence of complications as0than11.76%in the control group,and the difference had statistical significance(P<0.05).Conclusion Triangleanastomosis shows significant effect in total laparoscopic distal radical gastrectomy of gastric cancer with highsecurity,and it is an ideal surgery of digestive tract reconstruction.