反穿刺结合UN-CUT吻合在腹腔镜下全胃切除术消化道重建中的应用价值

doi:10.3969/j.issn.1671-7171.2022.09.019

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Abstract 【Objective】 To investigate the clinical value of retropuncture combined with UN-CUT anastomosis in gastrointestinal reconstruction after laparoscopic total gastrectomy for gastric cancer.【Methods】A total of 138 patients with laparoscopic total gastrectomy admitted to our hospital from September 2018 to January 2021 were selected and divided into reverse puncture group (reverse puncture combined with UN-CUT anastomosis) and Roux-en-Y group according to different ways of digestive tract reconstruction and anastomosis, with 69 patients in each group. The postoperative complications, nutritional changes and follow-up results were compared between the two groups.【Results】There was no significant difference between the two groups in operation time, digestive tract reconstruction time, number of lymph nodes cleared, first liquid diet time, drainage tube removal time, and hospital stay (P>0.05); The incision length, the time of the first anal exhaust, and the amount of bleeding in the reverse puncture group were lower than those in the Roux-en-Y group, with significant differences (P<0.05). There was no significant difference between the two groups in terms of weight loss 1 and 3 months after operation and the reduction of ALB and HGB 1 month after operation (P>0.05); The decrease of ALB and HGB in the reverse puncture group was less than that in the Roux-en-Y group 3 months after operation, and the difference was statistically significant (P<0.05). There were 1 case of food loop emptying disorder and intestinal obstruction in the reverse puncture group, and 5 cases and 3 cases in the Roux-en-Y group respectively,without significant difference between the two groups (P>0.05). All patients were followed up for 3 months. The incidence of reflux esophagitis and Roux syndrome in the reverse puncture group was lower than that in Roux-en-Y group (P<0.05). 【Conclusion】 Reverse puncture combined with UN-CUT anastomosis has the advantages of maintaining intestinal continuity, shortening the surgical incision, reducing the incidence of postoperative reflux esophagitis and Roux syndrome, and improving the nutritional status of patients, which can be applied in clinical practice.

Key words： Stomach Neoplasms/SU Laparoscopy Gastrectomy Anastomosis,Roux-en-Y

Received: 19 October 2021

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R735.2

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	ZHANG Yin-ke
	HAN Xin-ping

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ZHANG Yin-ke,HAN Xin-ping. Clinical Value of Retropuncture Combined with UN-CUT Anastomosis in Gastrointestinal Reconstruction after Laparoscopic Total Gastrectomy[J]. JOURNAL OF CLINICAL RESEARCH, 2022, 39(9): 1349-1352.

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http://journal07.magtech.org.cn/yxlcyj/EN/10.3969/j.issn.1671-7171.2022.09.019 OR http://journal07.magtech.org.cn/yxlcyj/EN/Y2022/V39/I9/1349

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