腹腔镜近端胃切除双通道吻合术在早期胃癌中的应用

Application of Laparoscopic Proximal Gastrectomy with Dual Channel Anastomosis in the Patients with Early Gastric Cancer

目的:探究腹腔镜近端胃切除双通道吻合术对早期胃癌患者术后反流、生存质量及营养状态的影响。方法:将2022年1月—2023年12月福建省漳州市医院收治的80例早期胃癌患者根据随机数字表法分为对照组(40例)和观察组(40例)。对照组行全胃切除Roux-en-Y吻合术治疗,观察组则行腹腔镜近端胃切除双通道吻合术治疗。比较两组的术后反流发生率、手术前后的DeMeester评分、生存质量[癌症患者生命质量测定量表体系之胃癌量表(QLICP-GA)]及营养状态[血清总蛋白(TP)、白蛋白(ALB)、血红蛋白(Hb)及患者主观整体营养评估量表(PG-SGA)]。结果:观察组的术后反流发生率显著低于对照组,差异有统计学意义(P<0.05)。术前,两组DeMeester评分、QLICP-GA评分、血清TP、ALB、Hb及PG-SGA评分比较,差异均无统计学意义(P>0.05);术后1个月,观察组的DeMeester评分指标均显著优于对照组,QLICP-GA各维度评分及血清TP、ALB、Hb均显著高于对照组,PG-SGA评分构成比显著优于对照组,差异均有统计学意义(P<0.05)。结论:腹腔镜近端胃切除双通道吻合术可有效控制早期胃癌患者的术后反流及改善其生存质量、营养状态,因此在早期胃癌患者中的应用值得肯定。

Objective:To investigate the influence of laparoscopic proximal gastrectomy with dual channel anastomosis for postoperative reflux,quality of life and nutritional state of patients with early gastric cancer.Method:A total of 80 patients with early gastric cancer admitted to Zhangzhou Municipal Hospital of Fujian Province from January 2022 to December 2023 were divided into control group(40 cases)and observation group(40 cases)by the random number table method.The control group was treated with Roux-en-Y anastomosis for total gastrectomy,the observation group was treated with laparoscopic proximal gastrectomy with dual channel anastomosis.Then the postoperative reflux rates,DeMeester score,life quality[quality of life instruments for cancer patients-gastric cancer(QLICP-GA)]and nutritional state[serumtotal protein(TP),abumin(ALB),hemoglobin(Hb)and patient-generated subjective global assessment(PG-SGA)]before and after operation of two groups were compared.Result:The postoperative reflux rate of observation group was significantly lower than that of control group,the difference was statistically significant(P<0.05).Before operation,the DeMeester scores,QLICP-GA scores,serum TP,ALB,Hb and PG-SGA scores of two groups were compared,the differences were not statistically significant(P>0.05);at 1 month after operation,the DeMeester scores of observation group were significantly better than those of control group,the various dimensions scores of QLICP-GA and serum TP,ALB,Hb were significantly higher than those of control group,the composition of PG-SGA score was significantly better than that of control group,the differences were statistically significant(P<0.05).Conclusion:The laparoscopic proximal gastrectomy with dual channel anastomosis can effectively control the postoperative reflux and improve the quality of life and nutritional state of patients with early gastric cancer,so its application in patients with early gastric cancer is worthy of recognition.