全腹腔镜胃部分离断后胃肠吻合术治疗老年胃癌合并幽门梗阻的远期疗效

Long-term Efficacy of Total Laparoscopic Gastroenteric Anastomosis After Partial Gastrectomy in the Treatment of Elderly Gastric Cancer Complicated with Pyloric Obstruction

目的探究全腹腔镜胃部分离断后胃肠吻合术(TLSPGJ)治疗老年胃癌(GC)合并幽门梗阻(PO)的远期疗效。方法选择2018年3月-2021年3月佳木斯市中心医院收治的62例老年GC并PO患者为研究对象,采用随机数字表法分为对照组与观察组,各31例。对照组行常规胃空肠吻合术治疗,观察组应用TLSPGJ治疗,比较两组围术期指标[术中出血量、术后视觉模拟评分(VAS)、胃管留置时间、术后首次进食时间、术后住院时间]、手术并发症、生活质量(QLQ-ST022)评分及远期疗效(术后1年生存率、幽门梗阻复发率)。结果观察组术中出血量、术后VAS评分小于对照组,胃管留置时间、术后首次进食时间、术后住院时间短于对照组,差异有统计学意义(P<0.05);观察组手术并发症总发生率低于对照组,差异有统计学意义(P<0.05);两组QLQ-ST022评分均低于治疗前,且观察组QLQ-ST022评分低于对照组,差异有统计学意义(P<0.05);观察组术后1年生存率高于对照组,幽门梗阻复发率低于对照组,差异有统计学意义(P<0.05)。结论TLSPGJ治疗老年GC合并PO效果确切,可减少手术出血,减轻术后疼痛,缩短患者的恢复时间,且并发症少,有助于改善患者生存质量,远期疗效理想。

Objective To investigate the long-term efficacy of total gastrointestinal anastomosis after total laparoscopic partial gastrectomy(TLSPGJ)in the treatment of elderly gastric cancer(GC)complicated with pyloric obstruction(PO).Methods A total of 62 elderly patients with GC and PO who were admitted to Jiamusi Central Hospital from March 2018 to March 2021 were selected as the research objects.They were divided into the control group and the observation group by random number table method,with 31 cases in each group.The control group was treated with conventional gastrojejunostomy,and the observation group was treated with TLSPGJ.The perioperative indexes[intraoperative blood loss,postoperative visual analogue scale(VAS),gastric tube indwelling time,postoperative first feeding time,postoperative hospital stay],surgical complications,quality of life(QLQ-ST022)score and long-term efficacy(1-year survival rate and recurrence rate of pyloric obstruction)were compared between the two groups.Results The intraoperative blood loss and postoperative VAS score in the observation group were less than those in the control group,and the gastric tube retention time,postoperative first feeding time and postoperative hospitalization time were shorter than those in the control group,the difference was statistically significant(P<0.05).The total incidence of surgical complications in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).The QLQ-ST022 scores of the two groups were lower than those before treatment,and the QLQ-ST022 score of the observation group was lower than that of the control group,and the difference was statistically significant(P<0.05).The 1-year survival rate of the observation group was higher than that of the control group,and the recurrence rate of pyloric obstruction was lower than that of the control group(P<0.05).Conclusion TLSPGJ is effective in the treatment of elderly GC combined with PO,which can reduce surgical bleeding,relieve postoperative pain,shorten the recovery time of patients,and has fewer complications,which is helpful to improve the quality of life of patients,and the long-term effect is ideal.