远端胃癌根治切除术后不同吻合方式对消化道重建的近期疗效分析

Short-term Effect of Different Anastomosis Methods on Digestive Tract Reconstruction after Radical Resection of Distal Gastric Cancer

目的对比与分析远端胃癌根治切除术后不同吻合方式对消化道重建的近期疗效。方法选择远端胃癌患者130例,根据吻合方式的不同分为观察组82例与对照组48例。所有患者都给予远端胃癌根治切除术,对照组采用单吻合器吻合,观察组采用双吻合器吻合,对比两组近期疗效。结果观察组的淋巴结清扫数、术后肛门排气时间、下床活动时间与住院时间显著少于对照组(P<0.05)。观察组术后1 d、2 d与3 d的疼痛VAS评分都显著低于对照组(P<0.05)。观察组术后14 d的切口出血、切口感染、吻合口瘘、吻合口梗阻、腹腔感染等并发症发生情况显著少于对照组(P<0.05)。两组术后1个月的血红蛋白与白蛋白值都显著高于术前1 d(P<0.05),观察组也显著高于对照组(P<0.05)。结论双吻合器在远端胃癌根治切除术后消化道重建的应用有利于促进患者康复,缓解疼痛,减少术后并发症的发生,促进患者恢复营养状况。

Objective To compare and analyze the short-term effects of different anastomosis methods on gastrointestinal reconstruction after radical resection of distal gastric cancer.Methods 130 patients with distal gastric cancer were selected and were divided into 82 patients in the observation group and 48 patients in the control group according to the different anastomosis methods.All patients were underwent radical resection of distal gastric cancer,the control group was treated with single stapler anastomosis,and the observation group was treated with double stapler anastomosis.The short-term effects of the 2 groups were compared.Results The lymph node dissection,postoperative anal exhaust time,bed-out time and hospital stay were significantly less in the observation group than the control group(P<0.05).The pain VAS scores of the observation group were significantly lower than those of the control group at 1 d,2 d and 3 d after operation(P<0.05).The complication of incision hemorrhage,wound infection,anastomotic leakage,anastomotic obstruction and abdominal infection at 14 days after operation were significantly less than that of the control group(P<0.05).The hemoglobin and albumin values of the 2 groups at 1 month after operation were significantly higher than those of the preoperative 1 d(P<0.05),and the observation group were also significantly higher than the control group(P<0.05).Conclusion The application of double stapler in the reconstruction of digestive tract after radical resection of distal gastric cancer is beneficial to promote rehabilitation,relieve pain,reduce postoperative complications and promote the recovery of nutritional status.