圆形吻合器与直线吻合器在远端胃癌手术毕Ⅱ式吻合术中的效果比较

Circular stapler versus linear stapler in Billroth Ⅱanastomosis after distal gastric cancer surgery

  • 摘要:
      目的  比较圆形吻合器与直线吻合器在远端胃癌手术毕Ⅱ式吻合术中行消化道重建的效果。
      方法  选取80例行根治性远端胃大部切除术的胃癌患者,采用随机数表法分为吻合器A组(n=40)与吻合器B组(n=40)。吻合器A组、B组分别采用圆形吻合器与直线吻合器行消化道重建,比较2组手术相关指标、术后胃肠道功能恢复时间、住院情况及并发症发生率。
      结果  2组患者手术时间、术中出血量、淋巴结清扫数、住院时间、住院费用比较,差异均无统计学意义(P>0.05)。吻合器B组术后首次排气时间、首次进食时间均显著短于吻合器A组(P < 0.05)。2组均未发生吻合口瘘和十二指肠残端瘘, 2组术后吻合口出血、吻合口狭窄、腹腔内感染、胃排空障碍等发生率以及总并发症发生率比较,差异均无统计学意义(P>0.05)。
      结论  远端胃癌手术毕Ⅱ式吻合术中采用圆形吻合器和直线吻合器行消化道重建均是安全有效的,但直线吻合器在术后胃肠道功能恢复方面更具优势。

     

    Abstract:
      Objective  To compare the effect of circular stapler and linear stapler in digestive tract reconstruction by Billroth Ⅱ anastomosis after distal gastric cancer surgery.
      Methods  A total of 80 patients with radical distal subtotal gastrectomy were selected and randomly divided into stapler group A (n=40) and stapler group B (n=40). Circular stapler and linear stapler were used to reconstruct digestive tract in stapler group A and stapler group B respectively. The operation related indexes, recovery time of gastrointestinal function, hospitalization and incidence rate of complications were compared between the two groups.
      Results  There were no significant differences in operation time, intra-operative blood loss, lymph node dissection, hospitalization time and hospitalization expenses between the two groups (P>0.05). The time to first exhaustion and the time to first meal in stapler group B were significantly shorter than those in stapler group A (P < 0.05). There was no anastomotic leakage or duodenal stump fistula in both groups. There were no significant differences in the incidence rates of anastomotic bleeding, anastomotic stenosis, intra-peritoneal infection, gastric emptying disorder and total complications between the two groups (P>0.05).
      Conclusion  Circular stapler and linear stapler are safe and effective in digestive tract reconstruction after distal gastric cancer operation, but linear stapler has more advantages in recovery of gastrointestinal function after operation.

     

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