临床外科杂志 ›› 2021, Vol. 29 ›› Issue (2): 154-157.doi: 10.3969/j.issn.1005-6483.2021.02.017

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全腹腔镜远端胃癌根治术中BⅡ+Braun与Uncut RouxenY不同吻合方式的临床对比研究

  

  1. 安徽省阜阳市肿瘤医院普外科
  • 出版日期:2021-02-20 发布日期:2021-02-20

Clinical comparative study of different anastomosis methods of BⅡ+Braun and Uncut RouxenY during radical laparoscopic radical gastrectomy

  • Online:2021-02-20 Published:2021-02-20

摘要: 目的:探讨全腹腔镜远端胃癌根治术中BⅡ+Braun与Uncut RouxenY不同吻合方式的临床效果和安全性。方法:我院2016年1月~2019年4月行全腹腔镜远端胃癌根治术病人95例,根据术中吻合方式不同分为两组,BⅡ+Braun组50例,行BⅡ+Braun吻合;Uncut RouxenY组45例,行Uncut RouxenY吻合,比较两组病人并发症、手术情况和住院费用。结果:RouxenY组胃肠功能恢复时间为(3.3±1.4)天,首次排气时间为(2.4±0.7)天,BⅡ+Braun组分别为(4.0±1.8)天和(2.9±0.8)天,两组比较差异有统计学意义(P<0.05),两组手术时间、术中出血量、淋巴结清扫数目、消化道重建时间、切口长度、首次下床活动时间、术后拔管时间、住院时间比较差异均无统计学意义(P>0.05)。两组住院费用及吻合器使用数量比较差异无统计学意义(P>0.05)。Uncut RouxenY组和BⅡ+Braun组并发症发生率分别为4.44%和18.0%,两组比较差异有统计学意义(P<0.05)。结论:两种吻合方式均可行,但Uncut RouxenY方式对胃肠功能影响较小,安全性较高。

关键词: 全腹腔镜, 远端胃癌根治术, 吻合方式, BⅡ+Braun, Uncut RouxenY

Abstract: Objective:To explore the effect and safety of different anastomosis methods of BⅡ+Braun and Uncut RouxenY during radical laparoscopic radical gastrectomy.Methods:A retrospective analysis of 95 patients undergoing radical laparoscopic radical gastrectomy from January 2017 to January 2019 in our hospital was divided into the BⅡ+Braun group according to the intraoperative anastomosis method(BⅡ+Braun anastomosis was performed,50 cases) and the Uncut RouxenY group(uncut RouxenY anastomosis,45 cases).The complications,surgery,hospitalization costs,recurrence and metastasis between the two groups were compared.Results:The recovery time of gastrointestinal function in the RouxenY group[(3.3±1.4)d] and the time of first exhaustion[(2.4±0.7)d] were shorter than the BⅡ+Braun group[(4.0±1.8)d,(2.9± 0.8)d],the difference was statistically significant(P<0.05).There was no statistically significant difference in operation time,intraoperative blood loss,number of lymph node dissection,digestive tract reconstruction time,incision length,first time out of bed activity,postoperative extubation time and hospital stay between the two groups(P>0.05).There was no significant difference in hospitalization costs and the number of staplers used between the two groups(P>0.05).The incidence of complications in the Uncut RouxenY group was lower than that in the BⅡ+Braun group(4.44% vs.18.0%,P<0.05).Conclusion:Both methods of anastomosis are safe and feasible,but the Uncut RouxenY method has less effect on gastrointestinal function and is safer.

Key words: total laparoscopy, distal gastric cancer radical operation, anastomosis, BⅡ+Braun, Uncut RouxenY

[1] 宋兴超, 路要武, 吴超等. 加速康复外科在全腹腔镜远端胃癌D2根治术中的应用[J]. 临床外科杂志, 2020, 28(5): 456-459.
[2] 周东, 何艳平, 李恒平, 黄卫东. 不同腹腔镜胃癌根治术对原发性胃癌病人胃肠动力、炎性应激及预后的影响分析[J]. 临床外科杂志, 2019, 27(5): 436-438.
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