腹腔镜外科杂志2023，Vol.28Issue(12)：898-905,919,9.DOI:10.13499/j.cnki.fqjwkzz.2023.12.898
双通道重建的腹腔镜近端胃癌根治术的安全性及生存质量评价
The safety and quality of life evaluation of laparoscopic proximal gastrectomy with double-tract reconstruction for proximal gastric cancer
摘要
Abstract
Objective:To explore the safety and quality of life of laparoscopic proximal gastrectomy with double-tract recon-struction(LPG-DTR)in the treatment of upper gastric cancer.Methods:A cohort study was conducted from Nov.2018 to Nov.2020 for patients with upper gastric cancer less than 4 cm in long diameter who underwent LPG-DTR,laparoscopic radical proximal gastrecto-my with esophagogastric anastomosis(LPG-EG),and laparoscopic total gastrectomy with Roux-en-Y anastomosis(LTG-RY).A total of 247 postoperative patients of upper gastric cancer were followed up for 1 year,including 59 patients in the LPG-DTR group,91 patients in the LPG-EG group,and 97 patients in the LTG-RY group.The postoperative complications,esophageal reflux symptoms,reflux esopha-gitis,body weight,hemoglobin and erythrocyte parameters were compared among the three groups at 1 year postoperatively.Results:There was no statistically significant difference in the incidence of postoperative short-term and long-term complications,anastomotic leakage and anastomotic stenosis among the three groups(P>0.05).The incidence of postoperative esophageal reflux symptoms and reflux esophagitis in the LPG-DTR group was lower than that in the LPG-EG group(P<0.0166),and there was no statistically signifi-cant difference compared with the LTG-RY group(P>0.05).At 1 year postoperatively,the body weight of the LPG-DTR group was higher than that of the LPG-EG group(P<0.05),and the difference was not statistically significant compared with that of the LTG-RY group(P>0.05);hemoglobin of the LPG-DTR group was higher than that of the LPG-EG group and the LTG-RY group(P<0.05);the proportion of abnormal erythrocyte parameters was lower than that in the LTG-RY group(P<0.0166),and there was no statistically sig-nificant difference compared with that of the LPG-EG group(P>0.05).Conclusions:Compared with LPG-EGand LTG-RY,LPG-DTR is a better quality of life surgical procedure for early gastric cancer and upper gastric cancer with tumor length less than 4 cm,without increasing postoperative complications,it can reduce postoperative esophageal reflux,and contribute to the maintenance of postoperative nutrition and reduction of postoperative anemia.关键词
胃肿瘤/近端胃切除术/全胃切除术/腹腔镜检查/双通道重建Key words
Stomach neoplasms/Proximal gastrectomy/Total gastrectomy/Laparoscopy/Double-tract reconstruction分类
医药卫生引用本文复制引用
张超凡,吴新军,李岩,陈炳合,薛明辉,秦蕾,魏勇,张倩倩,朱绍辉..双通道重建的腹腔镜近端胃癌根治术的安全性及生存质量评价[J].腹腔镜外科杂志,2023,28(12):898-905,919,9.基金项目
河南省医学科技攻关计划联合共建项目(2018020353) （2018020353）
