全腹腔镜下近端胃癌根治术后双通道吻合与Roux-en-y吻合临床疗效对比

张 鑫1, 张剑 锋*1, 杨 宇2, 赵 海霖2, 张 凯2, 罗 帅2
1、西南医科大学附属医院胃肠外科;广元市第一人民医院胃肠外科
2、广元市第一人民医院胃肠外科

摘要


目的：探究全腹腔镜下近端胃切除双通道吻合（PG-DT）与全胃切除Roux-en-y吻合（TG-RY）治疗近端胃癌的疗效及营养状态。方法：将2022年3月至2025年7月广元市第一人民医院收治的81例行全腹腔镜下近端胃癌根治术的患者纳入本次回顾性研究，按照治疗方式不同分组：51例患者接受PG术后DT治疗，纳入PG-DT组，30例患者接受TG术后RY治疗，纳入TG-RY组。比较两组手术结果（术中出血量、住院时间、手术时间、术后首次进食时间、术后首次排气时间）、并发症发生情况、术后1、3、6月营养状况（总蛋白、白蛋白、血红蛋白）。结果：两组患者在术中出血量、手术时间、住院时间、术后首次进食时间、术后排气时间差异均统计学意义（P＞0.05）。两组患者术前、术后1月总蛋白、白蛋白、血红蛋白差异均无统计学意义（P＞0.05），PG-DT组术后3月总蛋白、白蛋白、血红蛋白（64.25±6.00）（39.38±3.57）（114.98±13.67）g/L，均显著高于TG-RY组术后3月总蛋白、白蛋白、血红蛋白（61.57±7.06）（36.16±4.37）（106.70±10.43）g/L，PG-DT组术后6月总蛋白、白蛋白、血红蛋白（64.85±5.80）（39.70±3.35）（114.45±14.31）g/L，均显著高于TG-RY组术后6月总蛋白、白蛋白、血红蛋白（60.56±7.81）（35.07±5.69）（104.93±10.90）g/L。结论：PG-DT的手术效果良好，与TG-RY相比在术后营养状况方面有显著优势，两种手术方式在术后并发症、手术时间、住院时间等方面无明显差异。

关键词


全腔镜近端胃切除术；双通道重建；营养状况；近端胃癌

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参考


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