P形空肠袢空肠食管Roux-en-Y吻合术在腹腔镜辅助全胃切除术中的应用效果观察

Effect of P shape jejunum pan jejunum esophagus Roux-en-Y anastomosis in laparoscopic assisted total gastrectomy

目的探讨P形空肠袢空肠食管Roux-en-Y吻合术在腹腔镜辅助全胃切除术中的应用效果。方法选取2016年5月至2019年5月在本院行腹腔镜辅助全胃切除术的90例胃癌患者,按随机数字表法分为两组,各45例。实验组术中行P形空肠袢空肠食管Roux-en-Y吻合术,对照组行空肠食管Roux-en-Y吻合术。比较两组围术期指标、术后6个月营养状况、并发症发生率。结果实验组手术用时、胃肠功能恢复时间、住院时间分别为(167.92±28.75)min、(4.28±1.89)d、(12.49±4.07)d,均短于对照组,差异有统计学意义(P<0.05);两组术中失血量比较差异无统计学意义;实验组术后红细胞(RBC)、白蛋白(ALB)、血红蛋白(HGB)、总蛋白(TP)水平均高于对照组,差异有统计学意义(P<0.05);实验组术后腹胀、倾倒综合征发生率分别为4.44%、2.22%,均低于对照组,差异有统计学意义(P<0.05)。结论腹腔镜辅助全胃切除术行P形空肠袢空肠食管Roux-en-Y吻合术可缩短手术用时和术后胃肠功能恢复时间、住院时间,减少并发症发生,改善术后营养状况。

Objective To investigate the effect of P shape jejunum pan jejunum esophagus Roux-en-Y anastomosis in laparoscopic assisted total gastrectomy.Methods 90 patients with gastric cancer who underwent laparoscopic assisted total gastrectomy from May 2016 to May 2019 were divided into two groups according to the random number table method,with 45 cases in each group.In the experimental group,P shape jejunum pan jejunum esophagus Roux-en-Y anastomosis was performed,and the control group underwent jejunal esophagus Roux-en-Y anastomosis.The perioperative indicators,nutritional status and complications were compared between the two groups.Results The operation time,gastrointestinal function recovery time and hospitalization time of the experimental group were(167.92±28.75)min,(4.28±1.89)d,(12.49±4.07)d,which were shorter than the control group(P<0.05).There was no significant difference in blood loss between the two groups.The levels of red blood cells(RBC),albumin(ALB),hemoglobin(HGB)and total protein(TP)in the experimental group were higher than those in the control group(P<0.05).The incidence of postoperative abdominal distension and dumping syndrome in the experimental group were 4.44%and 2.22%,which was lower than the control group(P<0.05).Conclusion Laparoscopic assisted total gastrectomy with P shape jejunum pan jejunum esophagus Roux-en-Y anastomosis can shorten the time of surgery and hospitalization,reduce the incidence of complications,and improve the postoperative nutritional status.