腹腔镜全胃切除术后食管空肠不同吻合方式的临床疗效比较

Clinical efficacy of different esophagojejunol anastomosis methods after laparoscopic total gastrectomy

目的 比较腹腔镜全胃切除术后食管空肠π型吻合和Roux-en-Y吻合的安全性及可行性。方法采用回顾性队列研究方法,收集2019年5月—2021年5月期间潍坊市人民医院胃肠外科所有接受腹腔镜全胃切除术后食管空肠π型吻合(观察组)与食管空肠Roux-en-Y吻合(对照组)患者的临床资料,比较两组患者在围手术期情况、术后短期生活质量等方面的差异。结果 观察组手术时间、消化道重建时间、切口长度、首次排气时间、术后住院时间以及术后疼痛评分均优于对照组(P<0.05)。两组术后并发症比较,P>0.05。在生活质量方面,观察组术后1年时吞咽困难改善情况优于对照组(P<0.05)。结论 腹腔镜全胃切除术后食管空肠π型吻合术手术切口小且操作简单,疼痛轻、恢复快、住院时间短,因此π型吻合用于腹腔镜全胃切除术后消化道重建是安全可行的。

Objective To compare the safety and feasibility ofπ-type anastomosis and Roux-en-Y anastomosis of esophagojejunol after laparoscopic total gastrectomy.Methods A retrospective cohort study was used to collect clinical data of patients who underwent esophagojejulπ-type anastomosis(the observation group)and esophagojejul Roux-en-Y anastomosis(the control group)after laparoscopic total gastrectomy in the Department of Gastrointestinal Surgery of Weifang People's Hospital from May 2019 to May 2021.The differences in perioperative conditions and postoperative short-term quality of life between the two groups were compared.Results The scores of operation time,digestive tract reconstruction time,incision length,first exhaust time,postoperative hospitalization time and postoperative pain score in the observation group were better than those in the control group(P<0.05).The early complications were mainly pulmonary infection in the two groups,and there was no significant difference in postoperative complications between the two groups(P>0.05).In terms of quality of life,the dysphagia symptoms in the observation group were better than those in the control group 1 year after operation(P<0.05).Conclusionπ-type anastomosis of esophagojejunol after laparoscopic total gastrectomy has small incision,simple operation,light pain,quick recovery and short hospitalization time.Therefore,π-type anastomosis is safe and feasible for digestive tract reconstruction after laparoscopic total gastrectomy.