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目的:比较早期胃癌患者接受腹腔镜辅助远端胃切除术(LADG)后行Roux-en Y(RY)重建与Billroth Ⅰ(B Ⅰ)重建的短期结果。方法:2002年6月～2007年2月共有96例早期胃癌患者在日本大分大学医院接受了LADG,其中RY重建22例、BⅠ重建74例。比较RY组和BⅠ组患者的临床病理特点、术中情况、并发症、术后经过和血化验结果。结果:2组间术中情况、总并发症率、术后经过和血清学检查结果均无显著性差异(均P>0.05)。2组间手术相关并发症和一般并发症的发生率也无显著性差异(均P>0.05)。RY组有1例吻合口漏和2例胃排空障碍;而BⅠ组有2例吻合口狭窄。结论:LADG术后采用RY重建是安全可行的,具有和BⅠ重建同样的腹腔镜微创手术的优点。
Objective: To compare the short-term results of Roux-en Y (RY) reconstruction and Billroth Ⅰ (B Ⅰ) reconstruction after laparoscopic assisted distal gastrectomy (LADG) in patients with early gastric cancer. Methods: From June 2002 to February 2007, a total of 96 patients with early gastric cancer underwent LADG at Oita University Hospital in Japan. Among them, 22 cases were reconstructed by RY and 74 cases were reconstructed by B Ⅰ. The clinical and pathological features, intraoperative status, complications, postoperative blood test results were compared between RY group and BⅠgroup. Results: There was no significant difference between the two groups in terms of intraoperative status, total complication rate, postoperative and serological tests (all P> 0.05). There was no significant difference in the incidence of surgical complications and general complications between the two groups (all P> 0.05). There was 1 case of anastomotic leakage and 2 cases of gastric emptying disorder in RY group, and 2 cases of anastomotic stenosis in group BⅠ. Conclusion: The RY reconstruction after LADG is safe and feasible, which has the same advantages as laparoscopic minimally invasive surgery.