比较全腹腔镜下改良三角吻合技术与腔镜辅助下毕Ⅰ式吻合在胃癌根治术消化道重建中的应用价值。

选择2014年2月至2017年4月70例远端胃癌患者，随机分为A组与B组，各35例。所有患者均行远端胃切除联合D2淋巴结清扫，其中A组行全腹腔镜下改良三角吻合技术，B组行腔镜辅助下毕Ⅰ式吻合。采用SPSS19.0进行统计学分析，术中术后计量资料采用均数±标准差表示，采取独立t检验；并发症发生率比较行χ²检验，以P<0.05为差异有统计学意义。

A组手术时间与术中出血量均低于B组，清扫淋巴结数目多于B组，肛门首次排气时间、首次进流食时间与住院时间均短于B组，差异有统计学意义(P<0.05)。两组术后并发症总发生率分别为11.4%、17.1%，差异无统计学意义(P>0.05)。A、B组术后随访期间均未见吻合口狭窄、肿瘤复发及死亡。

较之腔镜辅助下毕Ⅰ式吻合，全腹腔镜下改良三角吻合技术更具微创性优势，手术时间缩短、血量减少出，根治性效果更佳，术后恢复更快，具有较大推广价值。

To compare the clinical outcome of total laparoscopic modified triangle anastomosis and laparoscopic-assisted BillrothⅠanastomosis for digestive tract reconstruction after radical gastrectomy.

From February 2014 to April 2017, 70 patients with distal gastric cancer were enrolled and randomly divided into group A (35 cases) and group B (35 cases). All patients underwent distal gastrectomy combined with D2 lymphadenectomy, patients in group A received total laparoscopic modified triangular anastomosis, while patients in group B received laparoscopic-assisted BillrothⅠanastomosis. Statistical analysis were performed by using SPSS19.0 software. Intraoperative and postoperative clinical indicators were presented as mean±standard deviation, and were examined by using t test. The postoperative complication rate were expressed as %, and were compared with χ² test. P<0.05 was thought to be statistically significant.

The operation time and intraoperative blood loss in group A were lower than those in group B, meanwhile the harvested lymph nodes in group A was more than that in group B, and exhaust time, first inflow time, hospital stay in group A were shorter than those in group B, with significant difference (P<0.05). The total incidence of postoperative complications was 11.4% in group A and 17.1% in group B, with no significant difference (P>0.05). There were no anastomotic stenosis, tumor recurrence and death during follow-up period.

Compared with laparoscopic-assisted BillrothⅠanastomosis, the total laparoscopic modified triangular anastomosis has more minimally invasive advantages, including shorter operation time, less blood volume, better oncological outcome, faster postoperative recovery, which is worthy of clinical promotion.