不同食管空肠吻合术的全腹腔镜根治性全胃切除术临床效果对比研究

Comparative study on clinical effect in total laparoscopic radical gastrectomy with different esophagojejunostomy

目的探讨不同食管空肠吻合术的全腹腔镜根治性全胃切除术临床效果。方法回顾性分析2018年1月至2020年6月全腹腔镜根治性全胃切除术的126例患者临床资料,根据吻合方式不同分为Overlap吻合组(Overlap组)、π形Roux-en-Y吻合组(π形组)和Roux-en-Y吻合组(常规组),每组42例。采用统计学软件SPSS 23.0进行分析,围手术期各项指标、营养指标等计量资料以(x±s)表示,多组间比较行单因素方差分析;并发症等计数资料采用X^(2)检验。P<0.05表示差异有统计学意义。结果π形组患者在总手术时间、吻合时间、术中出血量、术后住院时间、食用流质饮食时间等方面均优于Overlap组和常规组(P<0.05),且Overlap组优于常规组(P<0.05)。π形组患者术后并发症发生率显著低于其他两组(P<0.05)。结论采用π形Roux-en-Y吻合术在总手术时间、吻合时间及住院时间等方面疗效显著,且简单安全,术后并发症发生率低,有利于患者早日康复,值得在临床上推广。

Objective To investigate the clinical effect of total laparoscopic radical gastrectomy with different esophagogastrostomy.Methods The clinical data of 126 patients with laparoscopic radical gastrectomy from January 2018 to June 2020 were analyzed retrospectively.According to the different methods of anastomosis,they were divided into overlap group,πRoux-en-Y group(πgroup)and Roux-en-y anastomosis group(regular group),42 cases in each group.SPSS 23.0 was used for data analysis.Perioperative indicators,nutritional indicators and other measurement data were expressed as(x±s).One-way ANOVA was performed for comparison between multiple groups.X^(2) test was used for counting data such as complications,and P<0.05 indicated statistically significant differences.Results Patients inπshape group were superior to Overlap group and routine group in terms of total operation time,anastomosis time,intraoperative blood loss,postoperative hospital stay and liquid diet time(P<0.05),and Overlap group was superior to routine group(P<0.05).The incidence of postoperative complications inπshaped group was significantly lower than that in the other two groups(P<0.05).ConclusionπRoux-en-Y anastomosis is effective in operation time,anastomotic time and hospital stay.It is simple and safe,and the incidence of postoperative complications is low,which is conducive to the early recovery of patients,and is worth popularizing in clinical.