基于腹腔镜技术的不同吻合方式用于远端胃癌根治术的近中期随访比较

Comparison of different anastomoses methods based on laparoscopic technology in the early and middle follow-up of radical gastrectomy for distal gastric cancer

目的比较腹腔镜技术的不同吻合方式用于远端胃癌根治术的近中期随访结果。方法回顾性分析2018年1月至2019年12月接受手术治疗的95例远端胃癌患者病例资料,根据术中吻合方式不同分为两组,即裤形吻合组(n=S1例,行裤形吻合方式)和传统组(n=44例,行毕Ⅱ式+布朗吻合方式)。采用SPSS 23.0统计分析软件,手术相关指标以(x社s)表示,采用独立样本t检验;并发症、近中期复发率、转移率以[n(%)]表示,比较采用x检验;使用K-M法绘制预后曲线。P<0.05为差异有统计学意义。结果裤形吻合组患者手术时间、吻合时间、肛门排气时间住院时间均比传统组短(P<0.05);两组患者术中出血量相比,差异无统计学意义(P>O.05);术后随访12~36个月,中位随访时间为28.5个月,两组患者术后复发率、转移率相比,差异无统计学意义(P>0.05);裤形吻合组患者术后并发症总发生率(5.9%)小于传统组(20.5%)(P<0.05)。结论与毕Ⅱ式+布朗吻合方式相比,裤形吻合应用于远端胃癌根治术在术后恢复方面具有--定优势,术后并发症较少,且两者近中期预后相似。

Objective To compare the near and mid-term follow-up results of different anastomoses based on laparoscopic technology for radical gastric cancer surgery.Methods A retrospective analysis of the clinical data of 95 gastric cancer patients who underwent surgical treatment in from January 2018 to December 2019 was divided into two groups according to different intraoperative anastomosis method,namely the pants-shaped anastomosis group(n=51 cases,pants-shaped Anastomosis)and the traditional group(n=44 cases,Billroth II+Brown anastomosis).SPSS 23.0 statistical analysis software was performed,the related index of operation was expressed by(x±s),and independent sample t test was used.Complication,recurrence rate and metastasis rate were expressed by[n(%)],x2 test was used for comparison.P<O.05was considered statistically significant.Results The operation time,anastomosis time,anal exhaust time and hospital stay in pants anastomosis group were shorter than those in traditional group(P<O.05).There was no significant difference in intraoperative blood loss between the two groups(P>O.05).Postoperative follow-up was 12 to 36 months,with a median follow-up time of 28.5 months,with no significant difference in postoperative recurrence rate and metastasis rate between two groups(P>O.05);The total incidence of complications in pants anastomosis group(5.9%)was lower than that in traditional group(20.5%)(P<O.05).Conclusion Compared with Billroth II+Brown anastomosis,pantshaped anastomosis has certain advantages in postoperative recoveryin postoperative recovery in radical gastrectomy for distal gastric cancer,with fewer postoperative complications and similar prognosis in the near and medium term.