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Delta-shaped术和Billroth I术在腹腔镜远端胃癌根治术中的应用效果*
李锋,彭德伟,王梦桥,李文艺,邹燕蕾,周礼
0
(成都市第五人民医院普外科)
摘要:
【摘要】 目的 研究远端胃癌根治手术中实施全腹腔镜下三角吻合术(Delta-shaped)和腹腔镜辅助下毕Ⅰ式吻合术(Billroth I)应用效果。 方法 回顾性分析我院2015年5月~2018年5月实施腹腔镜远端胃癌根治术患者115例,根据手术方式依次分为Delta-shaped术组(33例)和Billroth I术组(82例)。两组均实施淋巴结清扫术,其中Delta-shaped术组实施Delta-shaped术,Billroth I术组实施Billroth I术。观察两组患者术中指标、组织标本情况、术后恢复情况,并统计术后并发症发生率。 结果 两组患者吻合时间比较差异无统计学意义(P>0.05);Delta-shaped术组初始手术时长长于Billroth I术组(P<0.05);Delta-shaped术组学习曲线后手术时长、术中出血量均短于Billroth I术组(P<0.05)。两组患者肿瘤大小、淋巴结清扫个数相当(P>0.05);Deltashaped术组切口长度、切缘距离均低于Billroth I术组(P<0.05)。Deltashaped术组术后镇痛时间、首次通气时间、胃肠功能恢复时间、下地时间、拆线时间、住院时间均短于Billroth I术组(P<0.05)。两组术后并发症发生率比较差异无统计学意义(P>0.05)。 结论 腹腔镜远端胃癌根治手术中实施Delta-shaped术近期优势高于Billroth I术,其手术创伤相对较小,术后恢复较快,临床应用价值较高。
关键词:  胃肿瘤  腹腔镜远端胃癌根治手术  胃三角吻合术  毕Ⅰ式吻合术
DOI:
基金项目:四川省医学会科研课题(Q18064)
Delta-shaped surgery and Billroth I in the radical operation of laparoscopic distal gastric cancer
LI Feng,PENG Dewei,WANG Mengqiao,LI Wenyi,ZOU Yanlei,ZHOU Li
(Department of General Surgery, Chengdu Fifth People's Hospital)
Abstract:
【Abstract】 Objective To study the application effects of total laparoscopic Deltashaped anastomosis (Delta-shaped) and laparoscopic assisted Billroth I anastomosis (Billroth I) in the radical operation of distal gastric cancer. Methods A retrospective analysis was performed on 115 patients with radical operation of laparoscopic distal gastric cancer from May 2015 to May 2018 in our hospital. They were divided into Delta-shaped group (33 cases) and Billroth I group (82 cases) according to the surgical procedures. The two groups were given lymph node dissection. Delta-shaped group was given Delta-shaped surgery. Billroth I group was given Billroth I surgery. The intraoperative indexes, tissue specimens and postoperative recovery were observed in the two groups, and the incidence rate of postoperative complications was counted. Results The anastomosis time in the two groups was comparable (P>0.05), and the initial operation time in Delta-shaped group was longer than that in Billroth I group (P<0.05). The operative time and intraoperative blood loss after learning curve in Delta-shaped group were shorter than those in Billroth I group (P<0.05). The tumor size and lymph node dissection quantity were similar in the two groups(P>0.05), and the incision length and margin distance in Delta-shaped group were lower than those in Billroth I group (P<0.05). The postoperative analgesia time, the first ventilation time, gastrointestinal function recovery time, ambulation time, suture removal time and hospital stay were shorter in Delta-shaped group than those in Billroth I group (P<0.05). The incidence rate of postoperative complications was comparable in the two groups(P>0.05). Conclusion The short-term advantage of Delta-shaped surgery in radical operation of laparoscopic distal gastric cancer is higher than that of Billroth I. Delta-shaped surgery has relatively smaller surgical trauma, faster postoperative recovery, and higher clinical application value.
Key words:  Gastric tumors  Radical operation of laparoscopic distal gastric cancer  Gastric Delta-shaped anastomosis  Billroth I anastomosis

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