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目的对比非离断式(Uncut)Roux-en-Y吻合和传统Roux-en-Y吻合应用于全腹腔镜远端胃癌根治术后消化道重建的安全性和短期疗效。方法回顾性分析国内10家单位共60例远端胃癌根治术后全腹腔镜消化道重建的胃癌病人临床资料,根据消化道重建方式不同分为Uncut Roux-en-Y组(Uncut组)34例,传统Roux-enY组(传统组)26例。结果 Uncut Roux-en-Y吻合在消化道重建时间方面用时更短[(51.5±13.3)min vs.(80.4±16.2)min,P=0.000],出血量更少[(60.0±35.6)m L vs.(132.9±65.1)m L,P=0.000],且在进食半流饮食时间方面具有优势[(4.6±1.5)d vs.(7.2±2.3)d,P=0.000]。两组病人在留置胃管时间、术后排气时间、进食流质时间和术后住院时间方面差异无统计学意义。两组病人均无围手术期死亡病例,并发症发生率差异无统计学意义(8.8%vs.7.7%,P=0.875)结论 Uncut Roux-en-Y吻合和传统Roux-en-Y吻合应用于全腹腔镜下消化道重建安全可行,Uncut Roux-en-Y吻合在重建时间和控制出血量方面具有优势。
Objective To compare the safety and short-term efficacy of uncut Roux-en-Y anastomosis and conventional Roux-en-Y anastomosis in the management of digestive tract reconstruction after radical laparoscopic radical gastrectomy. Methods The clinical data of 60 patients with gastric cancer who had undergone total laparoscopic digestive tract reconstruction after radical gastrectomy in 10 Chinese domestic units were retrospectively analyzed. According to the way of digestive tract reconstruction, they were divided into Uncut Roux-en-Y group (34 cases) , The traditional Roux-enY group (traditional group) 26 cases. Results Uncut Roux-en-Y anastomosis was less time-consuming [(51.5 ± 13.3) min vs. (80.4 ± 16.2) min, P = 0.000], and less bleeding [(60.0 ± 35.6) m L (132.9 ± 65.1) m L, P = 0.000], and had an advantage in eating a half-stream diet time (4.6 ± 1.5 vs. 7.2 ± 2.3 days, P = 0.000). There was no significant difference between the two groups in indwelling gastric tube time, postoperative exhaust time, food intake time and postoperative hospital stay. There was no significant difference in the incidence of complications between the two groups (8.8% vs.7.7%, P = 0.875). Conclusion The Uncut Roux-en-Y anastomosis fitted with the conventional Roux-en-Y Complete laparoscopic digestive reconstruction is safe and feasible, and Uncut Roux-en-Y anastomosis has advantages in reconstruction time and blood volume control.