腹腔镜辅助远端胃切除术重建方式的比较.docVIP

腹腔镜辅助远端胃切除术重建方式的比较 中日友好医院2010年第24卷第2期JournalofChina-JapanFriendshipHospital,2010Apr,Vo1.24,No.267 腹腔镜辅助远端胃切除术重建方式的比较 韦佳明1,黄林平,SeigoKitano2,NorioShiraishi (1.中日友好医院普外一科,北京100029;2.大分大学医学部第一外科,大分县由布市879—5593,日本) 摘要目的:比较早期胃癌患者接受腹腔镜辅助远端胃切除术(LADG)后行Roux—enY(RY)重建与BillrothI (BI)重建的短期结果.方法:2002年6月～2007年2月共有96例早期胃癌患者在日本大分大学医院接受了 LADG,其中RY重建22例,BI重建74例.比较RY组和BI组患者的临床病理特点,术中情况,并发症,术后 经过和血化验结果.结果:2组间术中情况,总并发症率,术后经过和血清学检查结果均无显着性差异(均Pgt; 0.05).2组间手术相关并发症和一般并发症的发生率也无显着性差异(均Pgt;0.05).RY组有1例吻合口漏和2 例胃排空障碍;而BI组有2例吻合口狭窄.结论:LADG术后采用RY重建是安全可行的,具有和BI重建同 样的腹腔镜微创手术的优点 关键词:胃肿瘤;远端胃切除术;腹腔镜;重建 中图分类号:R656.61文献标识码:A文章编号:1001—0025(2010)02—0067—04 doi:10.3969/j.issn.1001—0025.2010.02.001 Comparisonofreconstructionmethodsafterlaparoscopy-assisteddistalgastrectomy//WEIJia-ming, HUANGLin—ping,SeigoKitano,etal//JournalofChina-JapanFriendshipHospital,2010Apr,24(2): 67-70 AbstractObjective:TocomparethesafetyandfeasibilityofRoux-enY(RY)reconstructionwithBillrothI(B I)reconstructionafterlapamscopy—assisteddistalgastrectomy(LADG).Methods:Twenty-twopatientsunder— wentLADGwithRYreconstruction,and74patientsunderwentLADGwithBIreconstructionattheDepart— mentofSurgeryI,OitaUniversityHospitalduringJune2002toFebruary2007.Clinico—pathologicaldata,surgi? calfindings,complications,postoperativecourseandresultsofbloodtestswerecomparedbetweentheRY groupandtheBIgroup.Results:Surgicalfindings,overallcomplicationrate,postoperativecourse,andblood testresultsdidnothaveanysignificantdifferencesbetweenthetwogroups.Incidencesofsurgery-relatedand generalcomplicationswerealson0differencebetweenthetwogroups.IntheRYgroup,onecaseofanastomot— icleakageandtwocasesofgastricstasiswereobserved.IntheBIgroup,twocasesofanastomoticstenosis wereobserved.Conclusion:LADGwithRYissafeandhasthesameadvantagesoflaparoscopicsurgeryasthe onewithBIreconstruction. Keywordsgastriccancer;distalgastrectomy;laparoscopy;reconstruction AuthorsaddressDepartmentofSurgeryI,China—JapanFriendshipHospital,Beijing,100029,China 自从1991年首例腹腔镜辅助下远端胃切除 术(1aparoscopy—as