摘要
Abstract
Objective:To compare the efficacy of uncut Roux-en-Y esophagojejunostomy after laparoscopy total gastrectomy and open total gastrectomy.Methods:A total of 53 patients with gastric body carcinoma from Oct 2013 to Mar 2017 in our hospital were retrospectively collected and analyzed.The patients were divided into laparoscopic group (group A,27 cases) and open surgical group (group B,26 cases) according to the type of operation,and group A was further divided into totally laparoscopic group (TLG group,17 cases) and laparoscopy-assisted group (LAG group,10 cases).The observation index included operation time,reconstruction time,blood loss volume,the first time to flatus,hospital day and expenses,and early post complications.Results:The differences in operation time [(248±83.5) min vs (203.6±69.6) min],reconstruction time [(44.2±9.0) min vs (30.2±7.8) min] and blood loss volume [(231.8±145.2) mL vs (326.8±182.1) mL] between group A and B were statistically significant (t=2.098,P=0.040;t=6.041,P＜0.001;t=-2.103,P=0.040);the differences in the first time to flatus [(3.1±0.5) d vs (4.6±0.5) d],hospital day [(9.4±1.5) d and (14.6±2.0) d] and expenses [(31 000±3 000) yuan vs (42 000±2 000) yuan] of group A and group B were statistically significant (t=-10.918,P＜0.001;t=-10.735,P＜0.001;t=-15.643,P＜0.001).The operation time,reconstruction time and blood loss volume of TLG and LAG were (299±88) min vs (232± 55) min,(58.2±6.0) min vs (33.2±3.9) min,(216.1±36) mL vs (281.5±93) mL,respectively.This difference was significant (t=2.162,P=0.040;t=11.747,P＜0.001;t=-2.613,P=0.014).The first time to flatus,hospital day and expenses of group A and group B was (3.6±0.5) d vs (2.8±0.5) d,(9.8±1.2) d vs (9.0±1.8) d,and (31 000± 2 000) yuan vs (33 000±4 000) yuan,respectively.The difference was not significant (P＞0.05).The difference of early post complications occurred in group A and B was not significant (P＞0.05).Conclusion:Compared with open total gastrectomy,uncut Roux-en-Y esophagojejunostomy after laparoscopic total gastrectomy is characterized by less blood loss volume,shorter flatus and hospitalization time and less hospitalization expenses,however,longer operation time and reconstruction time.关键词
腹腔镜/非离断式Roux-en-Y吻合术/全胃切除Key words
laparoscopy/uncut Roux-en-Y reconstruction/total gastrectomy
