Comparative study on clinical effect in total laparoscopic radical gastrectomy with different esophagojejunostomy

doi:10.3877/cma.j.issn.1674-3946.2022.03.011

Abstract

Abstract:

Objective

To investigate the clinical effect of total laparoscopic radical gastrectomy with different esophagogastrostomy.

Methods

The clinical data of 126 patients with laparoscopic radical gastrectomy from January 2018 to June 2020 were analyzed retrospectively. According to the different methods of anastomosis，they were divided into overlap group，π Roux-en-Y group（π group）and Roux-en-y anastomosis group（regular group），42 cases in each group. SPSS 23.0 was used for data analysis. Perioperative indicators，nutritional indicators and other measurement data were expressed as（

x ˉ

±s）. One-way ANOVA was performed for comparison between multiple groups. χ² test was used for counting data such as complications，and P<0.05 indicated statistically significant differences.

Results

Patients in π shape group were superior to Overlap group and routine group in terms of total operation time，anastomosis time，intraoperative blood loss，postoperative hospital stay and liquid diet time（P<0.05），and Overlap group was superior to routine group（P<0.05）. The incidence of postoperative complications in π shaped group was significantly lower than that in the other two groups（P<0.05）.

Conclusion

π Roux-en-Y anastomosis is effective in operation time，anastomotic time and hospital stay. It is simple and safe，and the incidence of postoperative complications is low，which is conducive to the early recovery of patients，and is worth popularizing in clinical.

Key words: Stomach neoplasms, Laparoscopes, Gastrectomy, Esophagojejunostomy, Postoperative complications, Comparative effectiveness research

Yang Huang, Lianbang Zhou. Comparative study on clinical effect in total laparoscopic radical gastrectomy with different esophagojejunostomy[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2022, 16(03): 271-274.

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References 15

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组别	例	年龄		体重指数			性别
组别	例	（岁）		(kg/m²)			男		女
Overlap组	42	52.6±14.7		24.2±2.3			25		17
π形组	42	54.1±15.2		24.5±2.7			23		19
常规组	42	53.6±14.7		24.4±2.5			24		18
P		>0.05		>0.05			>0.05
组别	例	组织学分化				TNM分期
组别	例	高	中		低	I		Ⅱ		Ⅲ
Overlap组	42	10	15		17	12		8		22
π形组	42	12	14		16	13		8		21
常规组	42	13	14		15	12		9		21
P		>0.05				>0.05

组别	例	年龄		体重指数			性别
组别	例	（岁）		(kg/m²)			男		女
Overlap组	42	52.6±14.7		24.2±2.3			25		17
π形组	42	54.1±15.2		24.5±2.7			23		19
常规组	42	53.6±14.7		24.4±2.5			24		18
P		>0.05		>0.05			>0.05
组别	例	组织学分化				TNM分期
组别	例	高	中		低	I		Ⅱ		Ⅲ
Overlap组	42	10	15		17	12		8		22
π形组	42	12	14		16	13		8		21
常规组	42	13	14		15	12		9		21
P		>0.05				>0.05

组别	例	总手术时间 (min)	吻合时间 (min)
Overlap组	42	232.5±38.5^ac	51.3±14.2^ac
π形组	42	211.3±33.9^b	45.4±12.5^b
常规组	42	273.5±52.2	57.8±16.3
组别	例	术中出血量 (ml)	流质饮食时间(d)	术后住院时间(d)
Overlap组	42	248.6±53.5^ac	2.2±0.5^ac	11.1±3.1^ac
π形组	42	217.1±49.3^b	1.9±0.4^b	9.3±2.7^b
常规组	42	285.7±52.6	2.6±0.9	13.3±3.6

组别	例	总手术时间 (min)	吻合时间 (min)
Overlap组	42	232.5±38.5^ac	51.3±14.2^ac
π形组	42	211.3±33.9^b	45.4±12.5^b
常规组	42	273.5±52.2	57.8±16.3
组别	例	术中出血量 (ml)	流质饮食时间(d)	术后住院时间(d)
Overlap组	42	248.6±53.5^ac	2.2±0.5^ac	11.1±3.1^ac
π形组	42	217.1±49.3^b	1.9±0.4^b	9.3±2.7^b
常规组	42	285.7±52.6	2.6±0.9	13.3±3.6

组别	例	体重指数(kg/m²)		ABL(g/L)
组别	例	术前	术后6月	术前	术后6月
Overlap组	42	24.2±2.3	23.2±3.3	44.5±6.4	41.9±5.9
π形组	42	24.5±2.7	23.1±3.4	43.8±6.6	41.2±5.6
常规组	42	24.4±2.5	23.8±3.2	44.6±6.7	42.5±5.6
F		0.156	0.552	0.185	0.547
P		0.856	0.577	0.831	0.580
组别	例	RBC(×10¹²/L)		HGB(g/L)
组别	例	术前	术后6月	术前	术后6月
Overlap组	42	4.3±0.6	4.1±0.4	124.1±16.1	117.4±15.6
π形组	42	4.1±0.6	3.9±0.4	121.9±16.6	116.1±15.1
常规组	42	4.3±0.5	4.1±0.5	123.7±16.7	116.8±15.4
F		1.732	2.947	0.213	0.075
P		0.181	0.056	0.809	0.928
组别	例	TP(g/L)
组别	例	术前		术后6月
Overlap组	42	52.6±5.4		50.4±4.8
π形组	42	51.9±5.5		49.7±4.9
常规组	42	53.3±5.9		51.2±5.2
F		0.655		0.958
P		0.521		0.386

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