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目的探讨全腹腔镜下远端胃癌根治术中毕Ⅱ式吻合联合Braun吻合的临床疗效。方法回顾性分析笔者所在医院2012年6月至2014年6月期间收治的行全腹腔镜下远端胃癌根治术的186例远端胃癌患者的临床资料,根据术中消化道重建方式分为毕Ⅱ式+Braun吻合组86例和毕Ⅱ式吻合组100例,比较2组患者的临床疗效。结果毕Ⅱ式+Braun吻合组和毕Ⅱ式吻合组患者的手术时间、消化道重建时间、术中出血量、术后排气时间及住院时间比较差异均无统计学意义(P>0.05),而毕Ⅱ式+Braun吻合组的碱性反流性胃炎、十二指肠残端瘘、吻合口炎及术后胃瘫综合征的发生率均低于毕Ⅱ式吻合组(P<0.05)。结论在全腹腔镜下远端胃癌根治术中,毕Ⅱ式联合Braun吻合的应用减少了术后碱性反流性胃炎、十二指肠残端瘘、吻合口炎及术后胃瘫综合征的发生,是改善胃癌患者术后生存质量较理想的手术方式。
Objective To investigate the clinical effect of complete anastomosis of type Ⅱ anastomosis and Braun in radical laparoscopic radical gastrectomy for gastric cancer. Methods The clinical data of 186 patients with distal gastric cancer undergoing total laparoscopic radical gastrectomy from June 2012 to June 2014 in our hospital were retrospectively analyzed. According to the method of intraoperative digestive reconstruction, 86 cases of type Ⅱ + Braun anastomosis group and 100 cases of type Ⅱ anastomosis group, the clinical efficacy of the two groups were compared. Results There were no significant differences in the operation time, digestive tract reconstruction time, intraoperative blood loss, postoperative exhaust time and hospital stay in patients with complete type Ⅱ + Braun anastomosis and complete type Ⅱ anastomosis (P> 0.05) The incidences of alkaline reflux gastritis, duodenal stump fistula, anastomotic stoma and postoperative gastroparesis syndrome in group Ⅱ + Braun anastomosis were lower than those in group Ⅱ (P0.05) . Conclusion In the total laparoscopic radical gastrectomy for distal gastric cancer, the combination of type Ⅱ and Braun anastomosis reduces the incidence of postoperative alkaline reflux gastritis, duodenal stump fistula, anastomotic stoke and postoperative gastroparesis syndrome The occurrence of gastric cancer patients is to improve the quality of life after surgery is the ideal surgical approach.