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何天柱,孙元水.非离断式Roux-en-Y远端空肠储袋代胃术用于胃癌根治术后消化道重建的疗效观察[J].浙江中西医结合杂志,2018,28(9):
非离断式Roux-en-Y远端空肠储袋代胃术用于胃癌根治术后消化道重建的疗效观察
Observation of the Effect of Uncut Roux-en-Y Distal Jejunum Storage Bag Replacement for the Reconstruction of Digestive Tract after Radical Gastrectomy
投稿时间:2018-02-05  修订日期:2018-06-14
DOI:
中文关键词:  胃癌  胃癌根治术  Roux-en-Y  消化道重建
英文关键词:Gastric cancer  Radical gastrectomy for gastric cancer  Roux-en-Y  Digestive tract reconstruction
基金项目:浙江省科技计划项目(No.2017F30045);浙江省中医药科技计划项目(No.2018ZZ004)
作者单位E-mail
何天柱 浙江中医药大学 hetianlook@126.com 
孙元水 浙江省立同德医院 sunshui818@126.com 
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中文摘要:
      目的 探讨非离断式Roux-en-Y远端空肠储袋代胃术用于胃癌根治术后消化道重建的临床疗效。 方法 回顾性分析于浙江省立同德医院行根治性全胃切除术的73例胃癌患者,根据消化道重建方式的不同分为URY组(非离断组,42例)和RY组(对照组,31例),记录并比较两组患者的手术时间、消化道重建时间、术中出血量、术后排气时间、住院时间和术后并发症发生率,数据经过SPSS 17.0处理。结果 URY组手术时间短于RY组(P<0.05);URY组消化道重建时间及术中出血量显著低于RY组(P<0.01);URY组术后排气时间及住院时间短于RY组(P<0.05);URY组术后总体并发症发生率显著低于RY组(P<0.01),其中腹腔内感染和腹腔出血两组发生率无统计学意义(P>0.05);URY组Roux-en-Y 潴留综合征(RSS)发生率低于RY组,差异具有统计学意义(P<0.05);吻合口狭窄和十二指肠残端瘘两组均未出现。结论 胃癌患者行根治性全胃切除术后采用非离断式Roux-en-Y远端空肠储袋代胃术,可有效减少手术时间及消化道重建时间,减少术中出血量,缩短住院时间,并可以降低术后并发症的发生率,值得临床推广应用。
英文摘要:
      Objective To discuss the clinical effect of the uncut Roux-en-Y distal jejunum storage bag replacement for the reconstruction of digestive tract after radical gastrectomy. Methods A retrospective analysis of 73 cases of gastric cancer patients in Tongde Hospital of Zhejiang Province underwent radical gastrectomy, according to different methods of digestive tract reconstruction for URY group (non amputation group, 42 cases) and RY group (control group, 31 cases), and record the operation time, bleeding between the two groups of patients with digestive tract reconstruction time, the volume of intraoperative and postoperative exhaust time, hospitalization time and postoperative complication rate, data after SPSS 17 treatment. Results The operation time of URY group was shorter than that of group RY (P<0.05); the amount of bleeding in group URY digestive tract reconstruction time and intraoperative was lower than that in RY group (P<0.01); group URY, postoperative exhaust time and hospitalization time is shorter than the RY group (P<0.05); the overall complication rate of URY group were significantly lower than that of RY group (P<0.01). Intra abdominal infection and abdominal bleeding in two groups there was no statistical significance (P>0.05); group URY Roux-en-Y retention syndrome (RSS) incidence rate lower than the RY group, the difference was statistically significant (P<0.05); anastomotic stenosis and duodenal stump fistula in two groups were not there. Conclusion For patients with gastric cancer after total gastrectomy with uncut Roux-en-Y distal jejunal pouch on behalf of the stomach surgery, which can effectively reduce the operation time and the reconstruction of the digestive tract, reduce the amount of bleeding, shorten the hospitalization time, and can reduce the incidence of postoperative complications, worthy of clinical application.
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