腹腔镜根治性近端胃或全胃切除术中3种不同吻合器钉座置入方法的对比研究
发布时间：2018-08-16 15:28
【摘要】：目的探讨腹腔镜根治性近端胃或全胃切除术中3种吻合器钉座置入方法的优缺点。方法回顾分析我院2014年5月~2015年12月由同一组医生完成的53例腹腔镜根治性近端胃或全胃切除的临床资料,将17例采用辅助小切口置入吻合器钉座设为A组,16例采用经口置入钉钻系统(Or Vil)设为B组,20例采用反穿刺技术(reverse puncture device,PRD)设为C组,比较3组患者手术时间、钉座置入时间、术中出血、术后排气时间、住院时间、腹部切口长度、食管近切缘长度。结果 53例均顺利完成手术,围手术期无死亡。3组术中出血量[(158.8±34.4)ml vs.(136.2±33.0)ml vs.(160.2±35.6)ml,F=2.57,P=0.087]、肛门排气时间[2.0(1.0~12.5)d vs.1.5(1.0~2.5)d vs.1.5(1.0~3.0)d,χ~2=4.405,P=0.111]和并发症发生率[11.8%(2/17)vs.18.8%(3/16)vs.25.0%(5/20),χ~2=1.052,P=0.591]差异无统计学意义。A组钉座置入时间(18.5±4.8)min最短,显著短于B组(34.9±8.8)min(q=10.465,P0.05)和C组(23.1±5.1)min(q=3.099,P0.05)。C组食管切缘长度(4.5±0.5)cm最长,与B组(4.4±0.6)cm相比无统计学差异(q=0.583,P0.05),但显著长于A组(2.5±1.0)cm(q=11.856,P0.05)。B组切口长度(4.3±0.5)cm最短,与C组(4.5±0.6)cm相比无统计学差异(q=0.662,P0.05),但显著短于A组(8.6±2.1)cm(q=13.704,P0.05)。A组手术时间(208.5±24.4)min,显著短于B组(232.8±23.4)min(q=4.577,P0.05),但与C组(214.5±17.0)min比较无统计学差异(q=1.193,P0.05)。结论 3种吻合器钉座置入方法均安全可靠,辅助切口置入钉座可选择合适患者开展;Or Vil、RPD能避免体形限制,获得更长切缘;RPD操作更为简便,可作为腹腔镜下食管-残胃(空肠)吻合中理想的钉座置入方法进行推广。
[Abstract]:Objective to investigate the advantages and disadvantages of three stapler placement methods in laparoscopic proximal gastrectomy or total gastrectomy. Methods the clinical data of 53 cases of laparoscopic proximal gastrectomy or total gastrectomy performed by the same group of doctors in our hospital from May 2014 to December 2015 were retrospectively analyzed. Seventeen cases were divided into group A (n = 16), group B (n = 20), group B (n = 20) using (reverse puncture device technique. The time of operation and placement of nail pedestal were compared among the three groups. Intraoperative bleeding, postoperative exhaust time, hospital stay, abdominal incision length, esophageal proximal incisor length. 缁撴灉 53渚嬪潎椤哄埄瀹屾垚鎵嬫湳,鍥存墜鏈湡鏃犳浜，
本文编号：2186395
[Abstract]:Objective to investigate the advantages and disadvantages of three stapler placement methods in laparoscopic proximal gastrectomy or total gastrectomy. Methods the clinical data of 53 cases of laparoscopic proximal gastrectomy or total gastrectomy performed by the same group of doctors in our hospital from May 2014 to December 2015 were retrospectively analyzed. Seventeen cases were divided into group A (n = 16), group B (n = 20), group B (n = 20) using (reverse puncture device technique. The time of operation and placement of nail pedestal were compared among the three groups. Intraoperative bleeding, postoperative exhaust time, hospital stay, abdominal incision length, esophageal proximal incisor length. 缁撴灉 53渚嬪潎椤哄埄瀹屾垚鎵嬫湳,鍥存墜鏈湡鏃犳浜，
本文编号：2186395
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