摘要
目的探讨圆形吻合器与直线吻合器消化道重建对行远端胃癌根治术毕Ⅱ式吻合术患者临床效果的影响。方法选取行远端胃癌根治术毕Ⅱ式吻合术胃癌192例,将采用圆形吻合器消化道重建80例纳入圆形组,采用直线吻合器消化道重建112例纳入直线组。观察比较两组手术相关指标、术后恢复相关指标和术后并发症发生情况,术前和术后6个月营养状况指标,以及术后6个月生活质量。结果两组手术时间、术中出血量和清扫淋巴结总数比较差异均无统计学意义(P>0.05)。直线组术后肠道排气时间、拔除腹腔引流管时间、首次进食时间和住院时间均短于圆形组,差异有统计学意义(P<0.01)。术后1个月内,圆形组并发症总发生率为15.00%,直线组并发症总发生率为7.14%,两组比较差异无统计学意义(P>0.05)。术后6个月,两组体质量和血红蛋白(Hb)、白蛋白(ALB)均较术前增加,差异有统计学意义(P<0.01);直线组体质量和Hb、ALB均高于圆形组,但两组比较差异均无统计学意义(P>0.05)。术后6个月,两组健康状态调查简表(SF-36)各部分评分比较差异均无统计学意义(P>0.05)。结论圆形吻合器与直线吻合器消化道重建应用于远端胃癌根治术毕Ⅱ式吻合术患者均安全有效,但直线吻合器消化道重建更有利于术后恢复。
Objective To observe the effects of digestive tract reconstruction with round anastomat and linear anastomat on clinical therapeutic effect of patients undergoing BilirothⅡanastomosis for radical resection of distal gastric cancer.Methods A total of 192 cases who underwent BilirothⅡanastomosis for radical resection of distal gastric cancer were enrolled in this study.Among them,80 cases that underwent round anastomat for digestive tract reconstruction were included in round group,and 112 cases that were given linear anastomat for digestive tract reconstruction were included in linear group.The surgery-related indicators,postoperative recovery-related indicators,occurrence of perioperative complications,nutritional status indicators before surgery and at 6 months after surgery and the quality of life at 6 months after surgery were observed and compared between the two groups.Results There were no significant differences in the duration of surgery,intraoperative blood loss and total number of removed lymph nodes between the two groups(P>0.05).The postoperative intestinal exhaust time,abdominal drainage tube removal time,first feeding time,and length of hospital stay in linear group were shorter than those in round group(P<0.01).At 1 month after surgery,the total incidence of complications was 15.00%in the round group and 7.14%in the linear group,and there was no significant difference between the two groups(P>0.05).At 6 months after surgery,the body mass index,hemoglobin(Hb)and albumin(ALB)in the two groups were increased compared with those before surgery(P<0.01),and the above indicators were higher in the linear group than in the round group,but there were no statistically significant differences between the two groups(P>0.05).There were no statistically significant differences in the scores of each section in SF-36 scale between the two groups(P>0.05).Conclusion Both round anastomat and linear anastomat for digestive tract reconstruction are safe and effective in the BilirothⅡanastomosis for radical resection of distal gastric cancer,but the linear anastomat is more conducive to postoperative recovery.
作者
林永利
王英飞
张爽
LIN Yong-li;WANG Ying-fei;ZHANG Shuang(Department of Third General Surgery,Liaoyang Central Hospital,Liaoyang,Liaoning 111000,China)
出处
《临床误诊误治》
2021年第1期87-91,共5页
Clinical Misdiagnosis & Mistherapy
基金
辽宁省科学技术基金(2018020135)。
关键词
圆形吻合器
直线吻合器
消化道重建
远端胃癌根治术
毕Ⅱ式吻合术
胃肿瘤
治疗效果
安全性
Round anastomat
Linear anastomat
Digestive tract reconstruction
Radical resection of gastric cancer
BilirothⅡanastomosis
Stomach neoplasms
Treatment outcome
Safety
