[1]胡凯峰 夏亚斌** 许力 李树仁 黄晓旭 金岩 胡昊 杨成 彭悦.非离断式RouxenY吻合在腹腔镜远端胃癌根治术中的应用[J].中国微创外科杂志,2019,01(11):1000-1003.
 Hu Kaifeng,Xia Yabin,Xu Li,et al.Use of Uncut RouxenY Reconstruction in Laparoscopicassisted Distal Gastrectomy for Gastric Carcinoma[J].Chinese Journal of Minimally Invasive Surgery,2019,01(11):1000-1003.
点击复制

非离断式RouxenY吻合在腹腔镜远端胃癌根治术中的应用()
分享到:

《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2019年11期
页码:
1000-1003
栏目:
临床研究
出版日期:
2019-11-25

文章信息/Info

Title:
Use of Uncut RouxenY Reconstruction in Laparoscopicassisted Distal Gastrectomy for Gastric Carcinoma
作者:
胡凯峰 夏亚斌** 许力 李树仁 黄晓旭 金岩 胡昊 杨成 彭悦
(皖南医学院弋矶山医院胃肠外科,芜湖241001)
Author(s):
Hu Kaifeng Xia Yabin Xu Li et al.
Department of Gastrointestinal Surgery, Yijishan Hospital of Wannan Medical College, Wuhu 241001, China
关键词:
远端胃癌根治术消化道重建非离断RouxenY吻合腹腔镜Roux瘀滞综合征
Keywords:
Radical resection of distal gastric cancerDigestive tract reconstructionUncut RouxenY anastomosisLaparoscopyRoux stasis syndrome
文献标志码:
A
摘要:
目的探讨非离断(uncut)RouxenY吻合技术在腹腔镜辅助远端胃癌根治术消化道重建中的安全性和效果。方法回顾性分析2017年1月~2018年1月腹腔镜辅助远端胃癌根治术70例资料,2017年1~6月行RouxenY吻合(26例,RY组),2017年7月~2018年1月行非离断RouxenY吻合(44例,Uncut RY组)。术后随访6个月以上,比较其术后恢复情况、并发症发生率。结果Uncut RY组排气时间[(29.0±7.4)h]早于RY组[(38.0±5.7)h](t=-5.311,P=0000),Roux瘀滞综合征(Roux stasis syndrome,RSS)发生率(0%,0/44)低于RY组(34.6%,9/26)(P=0.000)。术后6个月,Uncut RY组体重、血浆白蛋白水平达到术前的比例高于RY组[68.2%(30/44) vs. 42.3%(11/26), χ2=4.509,P=0034;81.8%(36/44) vs. 50.0%(13/26), χ2=7.879,P=0.005]。 结论非离断RouxenY吻合术后并发症发生率低,能明显改善胃癌患者手术后生活质量及营养状况,是腹腔镜辅助远端胃癌根治术理想的消化道重建术式。
Abstract:
ObjectiveTo evaluate the safety and efficacy of uncut RouxenY anastomosis in laparoscopicassisted distal gastrectomy with gastrointestinal reconstruction.MethodsFrom January 2017 to January 2018, 70 cases of laparoscopic assisted distal gastrectomy for gastric cancer were analyzed retrospectively. A total of 26 cases between January to June of 2017 underwent RouxenY anastomosis (RY group), and 44 cases after July 2017 underwent uncut RouxenY anastomosis (Uncut RY group). All the patients were followed up for more than 6 months, and the recovery and complication rate were compared.ResultsThe time to flatus in the uncut RY group [(29.0±7.4) h] was earlier than that in the RY group [(38.0±5.7) h, t=-5.311, P=0.000], and the incidence of Roux stasis syndrome (RSS) was lower in the uncut RY group (0%, 0/44) than that in the RY group (34.6%, 9/26; P=0.000). The proportion that body weight and plasma albumin had reached preoperative levels in the uncut RY group was higher than those in the RY group [68.2% (30/44) vs. 42.3% (11/26), χ2=4.509, P=0.034; 81.8% (36/44) vs. 50.0% (13/26), χ2=7.879, P=0.005].ConclusionsThe uncut RouxenY anastomosis has advantage in improving the living quality and nutritional status of patients. It may be the preferred technique for reconstruction after laparoscopicassisted gastrectomy.

参考文献/References:

[1]Zang YF,Li FZ,Ji ZP,et al.Application value of enhanced recovery after surgery for total laparoscopic uncut RouxenY gastrojejunostomy after distal gastrectomy.World J Gastroenterol,2018,24(4):504-510.
[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(第8版)简介及解读.中国实用外科杂志,2017,37(1):16-17.
[3]陈凛,卢灿荣.新版日本胃癌“处理规约”和“治疗指南”之解读.临床外科杂志,2012,20(1):10-14.
[4]中华医学会外科学分会.胃切除术后消化道重建技术专家共识.中国实用外科杂志,2014,34(3):205-212.
[5]中国胃肠肿瘤外科联盟,中国抗癌协会胃癌专业委员会.中国胃肠肿瘤外科术后并发症诊断登记规范专家共识(2018版).中国实用外科杂志,2018,38(6):589-595.
[6]中华医学会消化病学分会.2014年中国胃食管反流病专家共识意见.胃肠病学,2015,20(3):155-167.
[7]徐军明,彭志海,李祖栋,等.胃切除术后非离断式RouxenY消化道重建的临床研究.中华胃肠外科杂志.2004,7(1):18-20.
[8]白洋,傅卫.Roux淤滞综合征研究现状.中华消化外科杂志,2015,14(7):593-595.
[9]赵天天,鲍传庆,许炳华,等.非离断式RouxenY吻合在腹腔镜根治性全胃切除术中的应用.中国微创外科杂志,2018,18(12):1095-1107.
[10]柳金强,周威,张磊,等.胃癌远端胃大部切除术后两种消化道重建方式的配比分析.现代肿瘤医学,2016,24(7):1088-1091.
[11]熊建波,李正荣,罗贤施,等.Uncut RouxenY吻合在腹腔镜辅助下胃癌根治术中的临床应用.实用医学杂志,2018,34(19):3203-3206.
[12]石磊,陈平,赵伟,等.非离断式RouxenY吻合在腹腔镜全胃切除术消化道重建中的应用.中华现代普通外科进展,2013,16(12):939-946.
[13]Otauka R,Natsume T,Maruyama T,et al.Antecolic reconstruction is a predictor of the occurrence of roux stasis syndrome after distal gastrectomy. J Gastrointest Surg,2015,19(5):821-824.
[14]梁寒.胃癌远端胃切除术后消化道重建手术方式的选择及临床评价.中华消化外科杂志,2016,15(3):216-220.

备注/Memo

备注/Memo:
基金项目:安徽省高校省级科研重点项目(SK2018A0190,KJ2019A0429)**通讯作者,Email:77278431@qq.com
更新日期/Last Update: 2020-03-03