改良三角吻合在全腹腔镜远端胃癌根治术中的应用
本文选题:全腹腔镜 + 胃癌根治术 ; 参考:《重庆医科大学》2017年硕士论文
【摘要】:目的:探讨改良三角吻合在全腹腔镜远端胃癌根治术中运用的效果。方法:选取重庆医科大学附属第二医院胃肠外科2014年2月至2016年2月施行全腹腔镜远端胃癌根治术(totally laparoscopic distal gastrectomy,TLDG)并行B I式吻合的病例67例,其中传统三角吻合(conventional delta-shaped anastomosis,Con-DSA)35例,改良三角吻合(modified delta-shaped anastomosis,Mod-DSA)32例,对比分析两组患者吻合口大小、吻合时间、术后并发症、住院时间、非计划再次手术等的情况。结果:两组患者吻合口直径[(28.7±3.1)mm vs(29.9±3.1)mm]、消化道重建时间[(19.0±3.1)min vs(18.9±3.0)min]、住院时间[(14.7±5.0)d vs(13.0±2.0)d]的比较,差异无明显统计学意义(P0.05),非计划再次手术率比较,差异无明显统计学(P0.05);但Con-DSA组术后总并发症多于Mod-DSA组,差异有统计学意义(P0.05),其中吻合口相关并发症发生率Con-DSA组多于Mod-DSA组,差异有统计学意义(P0.05)。结论:腹腔镜下改良三角吻合技术是一项安全、可行的消化道重建方式。
[Abstract]:Objective: to investigate the effect of modified triangular anastomosis in total laparoscopic distal gastric cancer radical operation. Methods: from February 2014 to February 2016, 67 cases of gastroenteric surgery in the second affiliated Hospital of Chongqing Medical University underwent total laparoscopic distal gastrectomy with (totally laparoscopic distal gastrectomy and B I anastomosis, including 35 cases of conventional delta-shaped anastomosis Con-DSA. 32 cases of modified delta-shaped anastomosis mod-DSA were analyzed. The size of anastomotic site, anastomosis time, postoperative complications, hospital stay and unplanned reoperation were compared between the two groups. Results: there was no significant difference in anastomotic diameter (28.7 卤3.1) mm vs (29.9 卤3.1mm), digestive tract reconstruction time (19.0 卤3.1) min vs (18.9 卤3.0 min) and hospital stay (14.7 卤5.0) d vs (13.0 卤2.0 d) between the two groups (P0.05). There was no significant difference (P0.05), but the total postoperative complications in Con-DSA group were more than those in Mod-DSA group (P0.05), and the incidence of anastomose-related complications in Con-DSA group was higher than that in Mod-DSA group (P0.05). Conclusion: laparoscopic modified triangular anastomosis is a safe and feasible way to reconstruct digestive tract.
【学位授予单位】:重庆医科大学
【学位级别】:硕士
【学位授予年份】:2017
【分类号】:R735.2
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