Abstract:
Objective
To investigate the safety and anti-reflux effect of modified tubular gastroesophagostomy in laparoscopic proximal gastrectomy for gastrointestinal reconstruction.
Methods
The clinical data of 107 patients who underwent laparoscopic proximal gastrectomy from January 2022 to December 2023 were retrospectively analyzed and divided into 2 groups according to different methods of digestive tract reconstruction.52 patients who received simple esophagostomy were used as control group, and 55 patients who received tubular gastro-esophagostomy were used as observation group.SPSS 27.0 software was used to analyze the data.Measurement data such as perioperative indexes and Gerd Q scores were represented by (± s ), and independent sample t test was performed.The total incidence of postoperative complications was compared by χ2 test, and the Clavien-Dindo classification of complications was compared by Z test.P＜0.05 was considered statistically significant.
Results
There was no significant difference in operation time, anastomosis time and Clavien-Dindo grade of complications between observation group and control group (P＞0.05).Compared with the control group, the indexes of first drinking time and average daily flow of gastric tube were significantly improved (P＜0.05).The total complication rate within 6 months after operation was lower than that of control group (5.5% vs.30.8%, P＜0.05).7 days after surgery, Gerd Q scale score of observation group was lower than that of control group (P＜0.05), postoperative nutritional indexes hemoglobin (HB), albumin (ALB) and body mass index (BMI) of observation group were better than those of control group (P＜0.05); 6 to 9 months after surgery, there were 4 patients in the observation group and 16 patients in the control group with mild reflux symptoms.The weight of all patients fluctuated from 4% to 5% of their preoperative body weight, and their diet basically returned to normal.
Conclusion
In patients with laparoscopic end-gastrectomy, tubular gastroesophagostomy can improve perioperative indicators, reduce the risk of complications, alleviate gastroesophageal reflux symptoms, and improve nutritional status.
Key words:
Stomach Neoplasms,
Laparoscopes,
Gastrectomy,
Tubular Gastroesophageal Anastomosis,
Postoperative Complications
Zhenzhen Li, Honggang Wang, Lili Cui, Yueqin Miu, Wanlu Liu. Safety and anti-reflux effect of modified tubular gastro-esophagostomy in laparoscopic proximal gastrectomy for gastrointestinal reconstruction[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2025, 19(02): 176-179.