腹腔镜下远端胃癌根治术联合非离断式Roux-en-Y吻合术的应用效果分析

Analysis of the application effect of laparoscopic distal gastrectomy combined with non-detached Roux-en-Y anastomosis

摘要:

目的 探讨腹腔镜下远端胃癌根治术（LDG）联合非离断式Roux-en-Y吻合术联合应用的效果。方法 回顾性分析2022年1月－2023年6月该院收治的96例行LDG的胃癌患者的临床资料。根据术中吻合方式不同，将患者分为离断组和非离断组，离断组（49例）行Roux-en-Y吻合术，非离断组（47例）行非离断式Roux-en-Y吻合术。比较两组患者术中指标、术后指标、术后并发症情况、营养指标水平和生活质量。结果 两组患者手术时间、消化道重建时间、清扫淋巴结数、术后6个月血红蛋白和白蛋白水平比较，差异均无统计学意义（P 0.05）；非离断组术中失血量较离断组少，术后造影剂胃排空时间、排气时间和进半流食时间较离断组短，并发症发生率较离断组低，胃肠道生活质量指数（GIQLI）总分较离断组高，差异均有统计学意义（P 0.05）。结论 LDG联合非离断式Roux-en-Y吻合术治疗胃癌，可减少术中失血量，降低术后并发症发生率，缩短胃肠生理功能恢复时间，且对营养摄取的影响小，有助于患者恢复生活质量。值得临床推广应用。

Abstract:

Objective To explore the effect of the combined application of laparoscopic radical gastrectomy (LDG) for distal gastric cancer and non-detached Roux-en-Y anastomosis.Methods The clinical data of 96 patients with gastric cancer were retrospectively analyzed who underwent LDG from January 2022 to June 2023. According to the different anastomosis methods during the operation, the patients were divided into the detached group and the non-detached group. The detached group (49 cases) underwent Roux-en-Y anastomosis, and the non-detached group (47 cases) underwent non-detached Roux-en-Y anastomosis. The intraoperative indicators, postoperative indicators, postoperative complications, nutritional index levels and quality of life of the two groups of patients were compared.Results There were no statistically significant differences between the two groups in surgical time, digestive tract reconstruction time, the number of lymph nodes cleared, hemoglobin and albumin levels at 6 months postoperatively (P 0.05). The non-detached group showed less intraoperative blood loss, shorter contrast agent gastric emptying time, exhaust time, and time to semi-liquid diet, a lower complication rate, and a higher total gastrointestinal quality of life index (GIQLI) scores compared to the detached group, with all differences being statistically significant (P 0.05).Conclusion LDG combined with non-detached Roux-en-Y anastomosis for the treatment of gastric cancer can diminish blood loss during surgery, decrease the frequency of postoperative complications, shorten the recovery time of gastrointestinal physiological functions, and have a small impact on nutrient intake, which contributes to the restoration of patients' quality of life. Therefore, it holds value for clinical practice and deserves broader application.