腹腔镜辅助根治性近端胃切除双通道重建的临床应用

Clinical application of laparoscopy-assisted radicalproximal gastrectomy with double-tract reconstruction

目的:探讨腹腔镜辅助根治性近端胃切除双通道重建术式的应用价值。方法:回顾分析2019年2月至2023年2月为70例早期近端胃癌患者行腹腔镜辅助近端胃切除术的临床资料。根据消化道重建方式分为食管胃重建组(n=31)与双通道重建组(n=39)。观察两组手术时间、消化道重建时间、出血量、术后恢复情况、反流性食管炎情况。结果:两组均成功完成手术,双通道重建组手术时间、消化道重建时间长于食管胃重建组,差异有统计学意义。两组术中出血量、术后通气时间、淋巴结清扫数量、术后住院时间、总并发症发生率差异无统计学意义。双通道重建组术后反流性食管炎发生率低于食管胃重建组。结论:腹腔镜辅助近端胃切除双通道重建术可减少近端胃癌术后反流性食管炎的发生,值得临床推广。

Objective:To explore the clinical application value of laparoscopy-assisted radical proximal gastrectomy with double-tract r econstruction.Methods:The retrospective study was conducted to analyze the clinical data of 70 patients with early upper gastric cancer who underwent laparoscopic-assisted radical proximal gastrectomy during the period from Feb.2019 to Feb.2023.According to the different methods of digestive tract reconstruction,there were two groups:esophagogastrostomy group(n=31)and double-tract r econstruction group(n=39).The operation time,digestive tract reconstruction time,bleeding volume,postoperative recovery and o ccurrence of reflux esophagitis of the two groups were observed.Results:All operations were successfully completed.The double-tract reconstruction group had longer time of surgery and digestive tract reconstruction compared to the esophagogastrostomy group,and the difference was statistically significant.There were no statistically significant differences between the two groups in terms of intraoperative blood loss,postoperative ventilation time,number of lymph node dissection,postoperative hospital stay and overall incidence of complications.The incidence of postoperative reflux esophagitis was significantly lower in the double-tract reconstruction group than that in the esophagogastrostomy group.Conclusions:Laparoscopic-assisted proximal gastrectomy with double-tract reconstruction can reduce reflux esophagitis and is worthy of clinical promotion.