Roux-en-Y改良P袢吻合术对减轻胃癌全胃切除术后胃食管反流病的临床价值

Clinical value of Roux-en-Y modified P-loop anastomosis in alleviating gastroesophageal reflux disease after total gastrectomy for gastric cancer

目的评价Roux-en-Y改良P袢吻合术对减轻胃癌全胃切除术后胃食管反流病(GERD)的临床价值。方法选择2015年10月至2017年3月吉林大学中日联谊医院收治的行全胃切除术的胃癌患者40例。其中19例患者采用常规Roux-en-Y吻合术(常规Roux-en-Y吻合术组),21例患者采用改良P袢吻合术(改良P袢吻合术组)。采用GerdQ量表评估所有患者术后1年出现GERD的情况。采用χ^2检验比较2组患者GERD发生率差异。结果所有患者手术均获得成功,无一例患者死亡。改良P袢吻合术组患者术后1年GERD发生率为4.8%(1/21),低于常规Roux-en-Y吻合术组的42.1%(8/19),且差异有统计学意义(χ^2=7.98,P<0.05)。结论Roux-en-Y改良P袢吻合术能显著减少胃癌全胃切除术后GERD的发生。

Objective To evaluate the clinical value of Roux-en-Y modified P-loop anastomosis in alleviating gastroesophageal reflux disease(GERD)after total gastrectomy for gastric cancer.Methods Forty patients with gastric cancer who underwent total gastrectomy from October 2015 to March 2017 in China Japan Union Hospital of Jilin University were selected.Roux-en-Y anastomosis was performed in 19 patients(Roux-en-Y anastomosis group)and modified P-loop anastomosis in 21 patients(modified P-loop anastomosis group).GerdQ scale was used to evaluate the occurrence of GERD in all patients one year after operation.Chi-square test were used to compare the incidence of GERD between the two groups.Results All patients were operated successfully without operative death,The incidence of GERD in the modified P-loop anastomosis group was 4.8%(1/21)one year after operation,which was lower than 42.1%(8/19)in the routine Roux-en-Y anastomosis group,and the difference was statistically significant(χ^2=7.98,P<0.05).Conclusion Roux-en-Y modified P-loop anastomosis can significantly reduce the incidence of GERD after total gastrectomy for gastric cancer.