改良双通道吻合法在完全腹腔镜近端胃切除术中的临床效果研究

Clinical effect of modified double channel anastomosis in complete laparoscopic proximal gastrectomy

目的分析改良双通道吻合法(DTR)在完全腹腔镜近端胃切除术中的应用效果。方法回顾性分析2018年5月至2022年5月96例近端胃癌患者资料,依据不同手术方式分为两组,每组患者各48例。对照组患者行腹腔镜全胃切除术+Roux-en-Y消化道重建术,观察组患者行完全腹腔镜近端胃切除术+改良DTR。采用统计学软件SPSS26.0分析数据。围手术期指标、营养指标等计量资料以(x±s)表示,采用独立样本t检验;术后并发症等计数资料采用x^(2)检验。P<0.05为差异有统计学意义。结果两组患者的手术时间、出血量、淋巴结清扫数目及术后下床时间、排气时间、住院时间相比无统计学意义(P>0.05);观察组患者术后3个月血红蛋白、白蛋白、总蛋白水平均高于对照组(P<0.05);观察组患者术后并发症总发生率显著低于对照组(10.4%s.27.1%,P<0.05)。结论改良DTR在完全腹腔镜近端胃切除术中具有较好的安全性和可行性,与腹腔镜全胃切除Roux-en-Y消化道重建术对比,有助于改善患者的营养状况,同时减少术后并发症。

Objective To analyze the effect of modified double channel anastomosis(DTR)in total laparoscopic proximal gastrectomy.Methods Data of 96 patients with proximal gastric cancer from May 2018 to May 2022 were retrospectively analyzed and divided into two groups according to different operation methods,with 48 patients in each group.Control group underwent laparoscopic total gastrectomy+Roux-en-Y digestive tract reconstruction,observation group underwent complete laparoscopic proximal gastrectomy+modified DTR.SPSS 26.O software was used to analyze the data.Perioperative indexes,nutritional indexes and other measurement data were expressed as(x±s),and independent sample t test was used.The statistical data of postoperative complications were analyzed by x^(2)test.P<0.05 was considered statistically significant.ResultsT There was no significant difference in operation time,blood loss,number of lymph node dissection,time to get out of bed,time to exhaust gas and time to stay in hospital between the two groups(P>0.05).The levels of hemoglobin,albumin and total protein in observation group were higher than those in control group 3 months after operation(P<0.05);The total incidence of postoperative complications in the observation group was significantly lower than that in the control group(10.4%us.27.1%,P<0.05).Conclusion The modified DTR has better safety and feasibility in total laparoscopic proximal gastrectomy.Compared with total gastrectomy Roux-en-Y digestive tract reconstruction,it can help improve the nutritional status of patients and reduce postoperative complications.