改良重叠法在癌症全腹腔镜全胃切除术后消化道重建中的应用评价

中国综合临床 Pub Date : 2019-07-01 DOI:10.3760/CMA.J.ISSN.1008-6315.2019.04.016

B. Ma, N. Cao

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引用次数: 0

摘要

目的评价改良重叠法在全腹腔镜胃癌全胃切除术消化道重建中的临床效果。方法收集2014年1月至2017年1月兰州大学附属第一医院行TLTG的86例胃癌患者资料。所有患者均行D2淋巴结切除术。采用传统重叠法重建44例患者的消化道(对照组)，采用改良重叠法重建42例患者的消化道(改良组)。比较两组患者术中、术后情况、术后无肿瘤生存、肿瘤复发及转移情况。随访持续到2018年2月。结果两组均成功行TLTG，无一例转剖腹手术。改良组食管空肠造口时间((20.4±2.3)min vs(46.5±4.4)min, t=9.493)、总手术时间((253.3±12.8)min vs(278.6±14.9)min, t=5.462)均显著短于对照组，两组比较差异均有统计学意义(P均0.05)。两组患者随访12~25个月。无复发或转移发生。结论与传统重叠法相比，改进的重叠法可简化吻合程序，缩短手术时间，获得有效可靠的吻合效果。关键词:胃肿瘤;腹腔镜检查;根治手术;Esophagojejunostomy

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Evaluation of modified Overlap method in digestive tract reconstruction after totally laparoscopic total gastrectomy for gastric cancer

Objective To evaluate the clinical effect of modified Overlap method in digestive tract reconstruction of totally laparoscopic total gastrectomy(TLTG) for gastric cancer. Methods The data of 86 patients with gastric cancer who underwent TLTG from January 2014 and January 2017 were collected from the First Hospital of Lanzhou University.All the patients underwent D2 lymphadenectomy.Forty-four patients′ digestive tracts were reconstructed with traditional Overlap method (control group), and 42 patients′ digestive tracts were reconstructed with modified Overlap method (modified group). The intraoperative and postoperative conditions, postoperative tumor-free survival, tumor recurrence and metastasis were compared between the two groups.Follow up lasted as of February 2018. Results TLTG was successfully performed in both groups, and no case was converted to laparotomy.The time of esophagojejunostomy ((20.4±2.3) min vs.(46.5±4.4) min, t=9.493), total operation time ((253.3±12.8) min vs.(278.6±14.9) min, t=5.462) in the modified group were significantly shorter than those in the control group, and there were significant differences between the two groups (all P 0.05). The two groups were followed up for 12~25 months.No recurrence or metastasis occurred. Conclusion Compared with traditional Overlap method, the modified Overlap method can simplify the anastomotic procedures, shorten operation time and achieve an effective and reliable anastomosis effect after TLTG. Key words: Gastric neoplasms; Laparoscopy; Radical surgery; Esophagojejunostomy

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来源期刊

中国综合临床

CiteScore

0.10

自引率

0.00%

发文量

16855

期刊介绍： Clinical Medicine of China is an academic journal organized by the Chinese Medical Association (CMA), which mainly publishes original research papers, reviews and commentaries in the field. Clinical Medicine of China is a source journal of Peking University (2000 and 2004 editions), a core journal of Chinese science and technology, an academic journal of RCCSE China Core (Extended Edition), and has been published in Chemical Abstracts of the United States (CA), Abstracts Journal of Russia (AJ), Chinese Core Journals (Selection) Database, Chinese Science and Technology Materials Directory, Wanfang Database, China Academic Journal Database, JST Japan Science and Technology Agency Database (Japanese) (2018) and other databases.