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目的介绍一种全胃切除术改良双贮袋Roux-en-Y吻合消化道重建方式,并与传统袢式吻合和Roux-en-Y吻合的中短期效果进行对比研究。方法 2008年5月至2010年3月河南省肿瘤医院普外科将106例因胃癌行根治性全胃切除术病人,随机分为3组分别接受改良双贮袋Roux-en-Y吻合、袢式吻合和Roux-en-Y吻合3种空肠代胃手术方式。比较3组病人的手术时间、术后并发症、住院总费用和住院时间。并于术后1、6、12个月分别进行胃癌病人生活质量调查问卷(QLQ-STO22)评分。结果改良双贮袋Roux-en-Y吻合在手术时间、术后并发症、住院总费用、住院时间等方面与其他两组比较差异无统计学意义。但生活质量评估(吞咽困难、疼痛、呃逆和饮食受限)明显优于其他两组。结论改良双贮袋Roux-en-Y吻合具有安全、术后生活质量高等优点。
Objective To introduce a total gastrectomy modified double-bag Roux-en-Y anastomosis digestive tract reconstruction method, and compared with the conventional 袢 anastomosis Roux-en-Y and short-term effect of the match. Methods From May 2008 to March 2010, 106 patients with radical gastrectomy for gastric cancer underwent radical gastrectomy in Henan Cancer Hospital. Patients were randomly divided into three groups. The patients received modified double-bag Roux-en-Y anastomosis, Anastomosis Roux-en-Y and three kinds of jejunal on behalf of the stomach surgery. The operation time, postoperative complications, total cost of hospitalization and hospital stay were compared between the three groups. The QLQ-STO22 scores of patients with gastric cancer were respectively obtained at 1, 6 and 12 months after operation. Results There was no significant difference in Roux-en-Y anastomosis between the two groups in terms of operation time, postoperative complications, total cost of hospitalization and hospital stay. However, quality of life assessments (dysphagia, pain, hiccups and diet restriction) were significantly better than the other two groups. Conclusion The improved dual-bag Roux-en-Y anastomosis has the advantages of high safety and postoperative quality of life.