摘要
目的 讨论双通道吻合术应用于近端胃切除术治疗胃癌手术时间延长的相关危险因素和对手术后并发症的影响。方法 回顾性分析2021年1月—2022年12月本院胃肠外科收治的应用双通道吻合术行近端胃切除术的47例食管胃结合部癌和近端胃癌患者的临床资料。中位手术时间为260 min,长时间组(n=24)的定义为手术时间≥260 min,短时间组(n=23)的定义为手术时<260 min。分析对手术时间产生影响的相关因素,并且比较两组术后并发症、反流性食管炎的发生情况。结果 长时间组体质量指数(BMI)、肿瘤浸润深度、肿瘤分化程度,手术出血量比例高于短时间组,差异具有统计学意义(P<0.05);多因素Logisyic回归分析显示,BMI是腹腔镜辅助近端胃切除双通道吻合术手术时间延长的独立影响因素(P<0.05且OR≥1)。长时间组总并发症的发生率高于短时间组(P<0.05)。结论 腹腔镜辅助近端胃切除双通道吻合术手术时间延长与患者BMI密切相关,而且手术时间的延长会加大术后发生总并发症的概率。
Objective To discuss the related risk factors for prolonged operation time of double-channel anastomosis in proximal gastrectomy for gastric cancer and its impact on postoperative complications.Methods The clinical data of 47 patients with tumors located in the esophagogastric junction and near the cardia who underwent double-channel anastomosis for proximal gastrectomy from January 2021 to December 2022 in the Department of Gastrointestinal Surgery,Heji Hospital,Changzhi Medical College were retrospectively analyzed.The median operation time was 260 min.The long-term group(n=24) was defined as operation time ≥260 min,and the short-term group(n=23) was defined as operation time <260 min.The factors affecting operation time were analyzed,and the occurrence of postoperative complications and reflux esophagitis between the two groups were compared.Results The body mass index(BMI),depth of tumor invasion,degree of tumor differentiation,and proportion of surgical bleeding in the long-term group were higher than those in the short-term group,with statistically significant differences(P<0.05).Multivariate Logistic regression analysis showed that BMI was an independent influencing factor for prolonged operation time of laparoscopic-assisted proximal gastrectomy with double-channel anastomosis(P<0.05 and OR≥1).The incidence of total complications in the long-term group was higher than that in the short-term group(P<0.05).Conclusions The prolonged operation time of laparoscope-assisted proximal gastrectomy with double-tract reconstruction is closely related to the patient 's BMI,and the prolonged operation time will increase the probability of total postoperative complications.
作者
李文斌
李莹莹
韩明
吴健
张敏
毕志彬
Li Wenbin;Li Yingying;Han Ming;Wu Jian;Zhang Min;Bi Zhibin(Graduate School of Changzhi Medical College,Changzhi,Shanxi 046000,China;The Affiliated Heji Hospital of Changzhi Medical College,Changzhi,Shanxi 046000,China)
出处
《齐齐哈尔医学院学报》
2025年第10期923-927,共5页
Journal of Qiqihar Medical University
基金
山西省卫生健康委科研基金资助项目(2022057)。
关键词
双通道吻合术
食管胃结合部肿瘤
近端胃切除术
手术时间
术后并发症
Double-tract reconstruction
Adenocarcinoma of esphagogastric junction
Proximal gastrectomy
Operation time
Postoperative complications
作者简介
通信作者:毕志彬,Email:bizhibin76800@126.com。
