医学临床研究
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医学临床研究  2025, Vol. 42 Issue (4): 642-644    DOI: 10.3969/j.issn.1671-7171.2025.04.023
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腹腔镜非离断Roux-en-Y吻合远端胃癌根治术治疗T1~4aN0~3M0胃癌的疗效
季良贵1, 李宁2, 叶中林3
1.固始县第三人民医院徐集镇中心卫生院普外科,河南 信阳 465200;
2.三门峡市中心医院普外科,河南 三门峡 472000;
3.河南信合医院普外科,河南 信阳 465299
Efficacy of Laparoscopic Roux-en-Y Distal Anastomosis for Radical Gastrectomy of T1-4aN0-3M0 Gastric Cancer
JI Lianggui, LI Ning, YE Zhonglin
General Surgery, Gushi County Third People's HospitalXuji Town Central Health Center, Xinyang Henan 465200
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摘要 【目的】探讨胃癌腹腔镜非离断Roux-en-Y吻合远端胃癌根治术治疗T1~4aN0~3M0胃癌患者的疗效以对生活质量的影响。【方法】80例T1~4aN0~3M0胃癌患者,根据手术方式不同将患者分为非离断组(n=43)和传统组(n=37),非离断组接受腹腔镜非离断Roux-en-Y吻合远端胃癌根治术治疗,传统组接受腹腔镜传统Roux-en-Y吻合远端胃癌根治术治疗。比较两组患者手术指标、手术前后胃液pH值、生活质量自评量表评分及并发症发生情况。【结果】两组患者术后住院天数、术后肛门排气时间、手术前胃液pH值及术后流质非正常进食时间,术后1 d胃液pH值、并发症总发生率比较,差异均无统计学意义( P>0.05) ;非离断组半流质非正常进食时间及手术时间短于传统组(P<0.05);非离断组出血量少于传统组(P<0.05);两组患者术后1 d、术后5 d胃液pH值较术前均显著升高,且非离断组术后5 d胃液pH值高于传统组(P<0.05);两组患者术后食欲情况、精神状况、家庭理解与配合、睡眠质量、日常生活情况、对癌症的认识评分高于术前(P<0.05),且非离断组术后各项评分高于传统组(P<0.05)。【结论】与腹腔镜传统Roux-en-Y吻合远端胃癌根治术相比,采用非离断Roux-en-Y吻合远端胃癌根治术治疗T1~4aN0~3M0胃癌患者,手术时间明显缩短,术中出血量更少,患者生活质量显著提高,值得临床推广使用。
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季良贵
李宁
叶中林
关键词 胃肿瘤胃切除术吻合术 Roux-en-Y治疗结果    
Abstract:【Objective】To explore the therapeutic efficacy and impact on the quality of life of laparoscopic non-disruptive Roux-en-Y distal anastomosis for radical gastrectomy in treating patients with T14aN03M0 gastric cancer. 【Methods】Eighty patients with T1-4aN0-3M0 gastric cancer were divided into the non-disruptive group (43 patients) and the traditional group (37 patients) based on the surgical approach. The non-disruptive group underwent laparoscopic non-disruptive Roux-en-Y distal anastomosis for radical gastrectomy, while the traditional group underwent traditional laparoscopic Roux-en-Y distal anastomosis for radical gastrectomy. The surgical indicators, pre- and post-operative gastric fluid pH values, self-rated quality of life scores, and incidence of complications were compared between the two groups. 【Results】There was no significant difference in postoperative hospital stay, time to postoperative anal exhaust, preoperative gastric fluid pH value, and time to liquid food intake after surgery, postoperative day 1 gastric fluid pH value, and total complication rate between the two groups (P>0.05). The non-disruptive group had shorter time to semi-liquid abnormal food intake and shorter operative time if compared to the traditional group (P<0.05). The non-disruptive group had less intraoperative blood loss than the traditional group (P<0.05). Both groups showed a significant increase in postoperative day 1 and day 5 gastric fluid pH values compared to preoperative level, while the non-disruptive group had even higher pH value on postoperative day 5 than the traditional group (P<0.05). Both groups showed a significant improvement in postoperative appetite, mental state, family understanding and cooperation, sleep quality, daily life, and cancer awareness compared to before surgery (P<0.05), and the non-disruptive group had higher postoperative scores than the traditional group (P<0.05). 【Conclusion】 Compared to traditional laparoscopic Roux-en-Y anastomosis for radical distal gastrectomy, the use of non-disruptive Roux-en-Y anastomosis for radical distal gastrectomy in treating patients with T14aN03M0 gastric cancer significantly shortens the operative time, reduces intraoperative blood loss, and significantly improves patients' quality of life, warranting its clinical promotion and use.
Key wordsStomach Neoplasms    Gastrectomy    Anastomosis Roux-en-Y    Treatment Outcome
收稿日期: 2023-03-27     
中图分类号:  R735.2  
引用本文:   
季良贵, 李宁, 叶中林. 腹腔镜非离断Roux-en-Y吻合远端胃癌根治术治疗T1~4aN0~3M0胃癌的疗效[J]. 医学临床研究, 2025, 42(4): 642-644.
JI Lianggui, LI Ning, YE Zhonglin. Efficacy of Laparoscopic Roux-en-Y Distal Anastomosis for Radical Gastrectomy of T1-4aN0-3M0 Gastric Cancer. JOURNAL OF CLINICAL RESEARCH, 2025, 42(4): 642-644.
链接本文:  
http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2025.04.023     或     http://journal07.magtech.org.cn/yxlcyj/CN/Y2025/V42/I4/642
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