[1]万玉峰.近端胃癌根治术中行胃食管前壁吻合的疗效及对患者胃肠功能恢复的影响[J].医学信息,2023,36(06):120-123.[doi:10.3969/j.issn.1006-1959.2023.06.026]
 WAN Yu-feng.Effect of Gastroesophageal Anterior Wall Anastomosis in Radical Gastrectomy for Proximal Gastric Cancer and its Effect on the Recovery of Gastrointestinal Function[J].Journal of Medical Information,2023,36(06):120-123.[doi:10.3969/j.issn.1006-1959.2023.06.026]
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近端胃癌根治术中行胃食管前壁吻合的疗效及对患者胃肠功能恢复的影响()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
36卷
期数:
2023年06期
页码:
120-123
栏目:
论著
出版日期:
2023-03-15

文章信息/Info

Title:
Effect of Gastroesophageal Anterior Wall Anastomosis in Radical Gastrectomy for Proximal Gastric Cancer and its Effect on the Recovery of Gastrointestinal Function
文章编号:
1006-1959(2023)06-0120-04
作者:
万玉峰
(佳木斯市中心医院普外一科,黑龙江 佳木斯 154003)
Author(s):
WAN Yu-feng
(The First Department of General Surgery,Jiamusi Central Hospital,Jiamusi 154003,Heilongjiang,China)
关键词:
近端胃癌根治术胃食管前壁吻合胃肠功能营养指标
Keywords:
Proximal radical gastrectomyGastroesophageal anterior wall anastomosisGastrointestinal functionNutrition index
分类号:
R735.2
DOI:
10.3969/j.issn.1006-1959.2023.06.026
文献标志码:
A
摘要:
目的 研究近端胃癌根治术中行胃食管前壁吻合的疗效及对患者胃肠功能恢复的影响。方法 选取2021年4月-2022年4月在我院行近端胃癌根治术的90例患者为研究对象,采用随机数字表法分为对照组和观察组,各45例。对照组采用胃食管后壁吻合,观察组采用胃食管前壁吻合,比较两组手术指标(手术时间、术中出血量、淋巴结清扫数目、胃肠道恢复时间)、胃功能指标[胃泌素(GAS)、胃动素(MOT)]、营养指标[血红蛋白(Hb)、血清白蛋白(ALB)、体质量(BMI)]、反流评分及并发症(吻合口出血、狭窄、漏以及肠梗阻)发生率。结果 两组手术时间、术中出血量、淋巴结清扫数目、胃肠道恢复时间比较,差异无统计学意义(P>0.05);两组术后4个月 GAS、MOT均升高,且观察组高于对照组(P<0.05);两组术后4个月Hb、ALB水平、BMI均低于术前,但观察组高于对照组(P<0.05);观察组术后3、6个月反流评分均低于对照组(P<0.05);两组并发症发生率比较,差异无统计学意义(P>0.05)。结论 近端胃癌根治术中行胃食管前壁吻合的疗效确切,可促进胃肠功能恢复,利于营养指标改善,不会增加并发症,可发挥更优的抗反流作用,利于残胃功能的保护,值得临床应用。
Abstract:
Objective To study the effect of gastroesophageal anterior wall anastomosis in radical resection of proximal gastric cancer and its effect on the recovery of gastrointestinal function.Methods A total of 90 patients who underwent radical gastrectomy for proximal gastric cancer in our hospital from April 2021 to April 2022 were selected as the research objects. They were divided into control group and observation group by random number table method, with 45 cases in each group. The control group was treated with gastroesophageal posterior wall anastomosis, and the observation group was treated with gastroesophageal anterior wall anastomosis. The operation indexes (operation time, intraoperative blood loss, number of lymph node dissection, gastrointestinal recovery time), gastric function indexes [gastrin (GAS), motilin (MOT)], nutritional indexes [hemoglobin (Hb), serum albumin (ALB), body mass (BMI)], reflux score and incidence of complications (anastomotic bleeding, stenosis, leakage and intestinal obstruction) were compared between the two groups.Results There was no significant difference in operation time, intraoperative blood loss, number of lymph node dissection and gastrointestinal recovery time between the two groups (P>0.05). The GAS and MOT of the two groups increased at 4 months after operation, and those in the observation group were higher than those in the control group (P<0.05). The levels of Hb, ALB and BMI in the two groups at 4 months after operation were lower than those before operation, but those in the observation group were higher than the control group (P<0.05). The reflux scores of the observation group were lower than those of the control group at 3 and 6 months after operation (P<0.05). There was no significant difference in the incidence of complications between the two groups (P>0.05).Conclusion The curative effect of gastroesophageal anterior wall anastomosis in radical resection of proximal gastric cancer is definite, which can promote the recovery of gastrointestinal function, improve the nutritional index, and will not increase complications. Meanwhile, it can play a better anti-reflux role and protect the function of residual stomach. It is worthy of clinical application.

参考文献/References:

[1]韩甜甜,周京旭,欧阳明子,等.73例胃癌患者的临床特征及预后分析[J].中医肿瘤学杂志,2021,3(1):8-12.[2]陕飞,李子禹,张连海,等.国际抗癌联盟及美国肿瘤联合会胃癌 TNM 分期系统简介及解读[J].中国实用外科杂志,2017,37(1):15-17. [3]Hu KW,Wang SL,Wang ZK,et al.Clinicopathological risk factors for gastric cancer: a retrospective cohort study in China [J].BMJ Open,2019,9(9):e030639.[4]陈杰,李政焰,季刚,等.体质量指数对胃癌根治术病人远期预后的影响[J].腹部外科,2019,8(4):239-245.[5]陶凯,黄庆兴,张万红,等.Siewert Ⅱ型和Ⅲ型食管胃结合部腺癌近端胃切除术间置空肠单通道和双通道消化道重建的前瞻性随机对照研究[J].中华消化外科杂志,2018,17(8):830-835.[6]王棣祥,王家兴,李捷,等.腹腔镜辅助远端胃癌根治术对老年进展期胃癌的短期疗效[J].武警医学,2019,30(6):479-483.[7]田金朝,王超,刘全胜.毕Ⅱ式+Braun吻合与单纯毕Ⅱ式吻合在腹腔镜远端胃癌根治术中的安全性及疗效观察[J].贵州医药,2022,28(9):12-15.[8]孙敏,金芝祥,蔡海,等.悬吊定位手工Braun吻合在腹腔镜下远端胃癌根治术的应用分析[J].东南国防医药,2022,20(9):12-17.[9]余盼攀,张健,孔文成,等.完全腹腔镜经腹经膈肌裂孔入路在SiewertⅡ型食管胃结合部腺癌根治术中的应用价值[J].中华消化外科杂志,2019,18(6):587-593.[10]Nguyen PM,Putoczki TL.Could the inhibition of IL-17 or IL-18 be apotential therapeutic opportunity for gastric cancer[J].Cytokine,2018,118(1):8-18.[11]王刚,李云川,李强,等.不同消化道重建方式在腹腔镜辅助远端胃癌根治术中的应用效果比较[J].中国综合临床,2022,7(1):156-160. [12]林宏明,周俊峰,王家兴,等.腹腔镜辅助近端胃切除双通道吻合在治疗早期近端胃癌中的应用[J].中华普通外科杂志,2019,34 (10):891-893.[13]李梦娇,朱正纲.近端胃癌根治术消化道重建方式的比较[J].外科理论与实践,2017,21(3):269-272.[14]Wang S,Lin S,Wang H,et al.Reconstruction methods after rad ical proximal gastrectomy: A systematic review[J].Medicine,2018,97(11):e0121.[15]王利东,田忠,刘源.近端胃切除联合间置空肠重建与全胃切除联合Roux-en-Y重建治疗近端胃癌的效果比较[J].山东医药,2017,57(9):58-60.[16]滕林志.腹腔镜双通路消化道重建在近端胃癌根治术中临床应用的初步探讨[D].济南:山东大学,2020.[17]舒同,文红梅,袁浩,等.两种不同吻合术式对近端胃癌根治术患者术后反流及机体营养恢复的影响[J].中华普外科手术学杂,2019,13(6):585-588. [18]Kinami S,Aizawa M,Yamashita H,et al.The incidences of metachronous multiple gastric cancer after various types of gastrectomy: analysis of data from a nationwide Japanese survey[J].Gastric Cancer,2021,24(1):22-30.[19]应可明,燕归如,孙民昌,等.近端胃癌术后胃食管反流的发生与预后的相关性分析[J].中国医师杂志,2018,20(11):1698-1700. [20]曾珂芮,韩华,卢通,等.线型吻合器与圆型吻合器在腹腔镜辅助远端胃癌根治术中的应用效果比较[J].山东医药,2022,15(1):65-68.

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更新日期/Last Update: 1900-01-01