| 时依,姜从桥.改良反穿刺应用在腹腔镜辅助下全胃切除术中的临床分析[J].安徽医药,2018,22(6):1075-1077. |
| 改良反穿刺应用在腹腔镜辅助下全胃切除术中的临床分析 |
| Clinical analysis of improved reverse puncture technique in laparoscopic assisted total gastrectomy |
| 投稿时间：2016-10-23 |
| DOI： |
| 中文关键词: 胃切除术 腹腔镜检查 改良反穿刺 |
| 英文关键词: Gastrectomy Laparoscopy Improved reverse puncture |
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| 中文摘要: |
| 目的 探究改良反穿刺在腹腔镜辅助下全胃切除术的临床应用效果。 方法 回顾分析2012年12月至2015年12月蚌埠医学院第一附属医院50例行腹腔镜辅助下全胃切除术(食管空肠Roux-en-Y 吻合)患者的临床资料,按照吻合方式分为观察组(改良反穿刺组)25例,对照组(荷包钳组)25例。将两组的手术耗时、切口长度、出血量、住院周期、肠道首次排气时间以及术后并发症发生情况进行比较分析。 结果 改良反穿刺组的手术切口长度明显短于荷包钳组[(4.5±0.9 ) cm比(8.0±1.3) cm,t=11.070,P＜0.05)]。两组(改良反穿刺组vs荷包钳组)在手术耗时[(210.4±33.4) min比(220.2±40.3) min,t=0.936,P=0.354)]、肠道首次排气时间[ (4.4±0.8) d比(4.0±0.7) d,t=1.881,P=0.066)]、出血量[ (130.4±30.2) mL比(138.3±28.1) mL,t=0.958,P=0.343)]、住院周期[ (10.8±1.2) d比(11.0±0.9) d,t=0.667,P=0.508)]以及术后并发症(吻合口瘘、切口不愈合及感染、小肠梗阻及肺部感染等)发生率(20%比8%,χ2=1.495,P=0.221)均差异无统计学意义。 结论 与荷包钳法相比,改良反穿刺法有更小的手术切口长度,且两组在术中手术耗时及出血量、术后肠道首次排气时间、住院周期及术后并发症发生率上无明显差异；在临床上有一定的应用价值。 |
| 英文摘要: |
| Objective To investigate the application of improved reverse puncture in laparoscopically assisted total gastrectomy. Methods The clinical data of 50 patients undergoing laparoscopically assisted total gastrectomy (Roux-en-Y anastomosis of esophagojejunostomy) in The First Affiliated Hospital of Bengbu Medical College from December 2012 to December 2015 were retrospectively analyzed.Patients were assigned into observation group (improved reverse puncture group) and control group (purse-string group),with 25 cases in each group,according to anastomotic methods.The time of operation,length of incision,amount of bleeding,length of hospitalization,first time of intestine drainage,and postoperative complications were compared between the two groups. Results The length of surgical incision in the improved reverse puncture group was significantly shorter than that of the purse-string group [(4.5±0.9 cm) vs(8.0±1.3) cm,t=11.070,P＜0.05)].The differences in the operation time [(210.4±33.4) min vs(220.2±40.3) min,t=0.936,P=0.354)],the first time of intestine drainage [(4.4±0.8) d vs(4.0±0.7) d,t=1.881,P=0.066)],the amount of bleeding [(130.4±30.2) mL vs(138.3±28.1) mL,t=0.958,P=0.343)],hospitalization period [(10.8±1.2) d vs(11.0±0.9) d,t=0.667,P=0.508)],and the incidences of postoperative complications such as anastomotic fistula,incision nonhealing and infection,small bowel obstruction and pulmonary infection in the improved anti-puncture group and purse-string group were not statistically significant (20% vs 8%,χ2=1.495,P=0.221). Conclusions Compared with the purse-string method,the improved reverse puncture method has a smaller incision length,and there are no significant differences between the two groups in the time and blood loss of the operation,the time of first postoperative bowel exhaust,the hospitalization period and the incidence of postoperative complications.It has a certain application value in clinic. |
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