论文部分内容阅读
目的比较Roux-en-Y吻合术和间置空肠手术在近端胃癌手术治疗中效果。方法 151例近端胃癌患者,行近端胃部分切除+间置空肠吻合术69例为观察组,全胃切除+Roux-en-Y吻合术82例为对照组,观察2组术后肺部感染、吻合口瘘、反流性食管炎、切口感染等并发症发生情况,比较2组术后生活质量Visick分级,以及术后1、3、5a患者生存率。结果 2组患者手术过程均顺利,观察组术后反流性食管炎发生率(26.1%)低于对照组(73.2%)(P<0.05),2组术后感染、吻合口瘘或吻合口出血、肠梗阻发生率比较差异均无统计学意义(P>0.05);观察组术后Visick分级1~2级比率(89.9%)高于对照组(45.1%)(P<0.05),术后1、3、5a生存率(97.1%、60.9%、46.4%)与对照组(90.2%、68.3%、48.8%)比较差异均无统计学意义(P>0.05)。结论近端胃切除+间置空肠吻合术和全胃切除+Roux-en-Y吻合术治疗近端胃癌疗效确切,前者消化道重建方式有助于提高术后生活质量,降低反流性食管炎发生率,可作为近端胃癌首选消化道重建方式。
Objective To compare the effects of Roux-en-Y anastomosis and jejunal surgery in the surgical treatment of proximal gastric cancer. Methods One hundred and fifteen patients with proximal gastric cancer underwent proximal partial gastrectomy and interdental jejunostomy in 69 cases. The total gastrectomy + Roux-en-Y anastomosis was performed in 82 cases as the control group. Two groups of postoperative lungs Infection, anastomotic fistula, reflux esophagitis, incision infection and other complications occurred. The Visick grading of postoperative quality of life, and postoperative 1,3,5a survival rate were compared. Results The operation of the two groups was successful. The incidence of reflux esophagitis in the observation group was lower than that in the control group (26.1% vs 73.2%, P <0.05). The postoperative infection, anastomotic fistula or anastomosis (P> 0.05). The Visick grading 1 ~ 2 ratio (89.9%) in the observation group was significantly higher than that in the control group (45.1%) (P <0.05) after operation, and the incidence of hemorrhage and intestinal obstruction was no significant difference The survival rates of 1,3,5a (97.1%, 60.9%, 46.4%) were not significantly different from those of the control group (90.2%, 68.3%, 48.8%) (P> 0.05). Conclusion proximal gastrectomy + interstitial jejunostomy and total gastrectomy + Roux-en-Y anastomosis for the treatment of proximal gastric cancer is effective, the former method of gastrointestinal reconstruction can help improve postoperative quality of life, reduce reflux esophagitis The incidence of proximal gastric cancer can be used as the preferred method of reconstruction of the digestive tract.