作者：施珊格, 黄宝桑, 邹庆杰, 杨长镖, 李瑞达, 黄家荣, 缪锦超, 刘赞伟

单位：广东省汕尾市海丰县彭湃纪念医院 普通外科，广东 汕尾 516400

Authors:  Shi Shange, Huang Baosang, Zou Qingjie, Yang Changbiao, Li Ruida, Huang Jiarong, Miao Jinchao , Liu Zanwei

Unit:  Department of General Surgery, Pen-pai Memorial Hospital, Haifeng 516400, Guangdong, China

摘要：

目的 探讨非离断式Roux-en-Y吻合方式在远端胃癌D2根治术中的临床应用价值。方法 纳入在广东省海丰县彭湃纪念医院行远端胃癌D2根治术患者50例,按照不同的消化道重建方式分为试验组(非离断式Roux-en-Y吻合)和对照组(传统Roux-en-Y吻合),每组各25例。分别比较两组病例的消化道重建及肛门恢复排气时间,术后吻合口/残端漏、吻合口炎/溃疡和Roux-en-Y滞留综合征等的发生率。结果 试验组消化道重建时间和肛门恢复排气时间分别为(46.92±4.31)min、(50.52±4.50)h,对照组分别为(50.32±4.65) min、(53.76±4.35)h,差异有统计学意义(P<0.05)。试验组2例发生Roux-en-Y滞留综合征,而对照组为10例,差异有统计学意义(P<0.05)。在吻合口/残端漏、吻合口炎/溃疡方面,两组差异无统计学意义(P>0.05)。结论 非离断式Roux-en-Y吻合用于远端胃癌D2根治术可以缩短术中消化道重建时间,同时减少Roux-en-Y滞留综合征发生率。

关键词：非离断式Roux-en-Y; 胃癌根治术; 临床疗效

Abstract：

Objective To explore the value of uncut Roux-en-Y gastrointestinal reconstruction in D2 radical resection of distal gastric cancer. Methods Fifty patients who underwent D2 radical resection of distal gastric cancer in our hospital were enrolled, and were divided into two groups (uncut Roux-en-Y anastomosis) and control group (conventional Roux-en-Y anastomosis) , 25 cases in each group. The gastrointestinal reconstruction time and time to initial anal exhaust, postoperative anastomotic/stump leakage, anastomotic stomatitis/ulcer and Roux-en-Y stasis syndrome were compared between the two groups. Results The gastrointestinal reconstruction time and the time to initial anal exhaust of the uncut Roux-en-Y group were (46.92±4.31) min and (50.52±4.50) h, respectively, while, the control group were (50.32±4.65) min and (53.76±4.35) h, respectively. The difference was statistically significant (P<0.05). Roux-en-Y stasis syndrome occurred in 2 cases in the uncut group, and 10 cases in the control group (P<0.05). In terms of anastomotic/stump leakage, anastomotic stomatitis/ulcer, the difference between the two groups was not statistically significant (P>0.05). Conclusion Uncut Roux-en-Y anastomosis for D2 radical resection of distal gastric cancer can shorten the time of gastrointestinal reconstruction during operation and reduce the incidence of Roux-en-Y stasis syndrome.

Key Words:  Uncut Roux-en-Y; Radical resection for gastric cancer; Clinical effect