CAJ | 학술논문

目的探讨不同吻合方式在腹腔镜胃肠旁路术治疗2型糖尿病中的临床疗效.方法将21例2型糖尿病患者根据不同的胃空肠吻合方式分为经口吻合器组(9例)和腹腔镜直线切割闭合器(Endo-GIA)组(12例),分析手术完成情况、并发症情况以及糖尿病治疗效果.结果本组21例均成功完成手术,无中转开腹,无明显并发症.两组的术中出血量、术后恢复时间之间相比差异无统计学意义(P＞0.05),经口吻合器组手术时间为( 126±29) min,明显短于Endo-GIA组(156±28) min(P ＜0.05),但经口吻合器组费用较高.经口吻合器组9例患者中,7例治愈,术后停用降糖药物,2例有效；Endo-GIA组12例患者中,10例治愈,2例有效.21例患者总治愈率为81％,总有效率为100％.两组的营养指标无明显改变.结论不同吻合方式对于2型糖尿病手术治疗效果相同.
목적 탐토불동문합방식재복강경위장방로술치료2형당뇨병중적림상료효.방법 장21례2형당뇨병환자근거불동적위공장문합방식분위경구문합기조(9례)화복강경직선절할폐합기(Endo-GIA)조(12례),분석수술완성정황、병발증정황이급당뇨병치료효과.결과 본조21례균성공완성수술,무중전개복,무명현병발증.량조적술중출혈량、술후회복시간지간상비차이무통계학의의(P＞0.05),경구문합기조수술시간위( 126±29) min,명현단우Endo-GIA조(156±28) min(P ＜0.05),단경구문합기조비용교고.경구문합기조9례환자중,7례치유,술후정용강당약물,2례유효；Endo-GIA조12례환자중,10례치유,2례유효.21례환자총치유솔위81％,총유효솔위100％.량조적영양지표무명현개변.결론 불동문합방식대우2형당뇨병수술치료효과상동.
Objective To evaluate treatment of type 2 diabetes mellitus (T2DM) by laparoscopic Roux-en-Y gastric bypass (LRYGB) using different amastomoses. Methods Twenty one T2DM patients were divided into two groups:transoral EEA (OrVil) and Endo-GIA according to ways of gastrointestinal anatomosis and underwent LRYGB. Clinical data including outcome of operation, complications,preoperative and postoperative oral glucose tolerance test (OGTT),Homa-IR,Homa-β,blood lipid and nutrition status were analyzed. Results LRYGB procedures were successfully performed in all the 21 patients with no conversion to open surgery.The difference of intraoperative blood loss,postoperative recovery time between two groups was not significant.The mean operation time in OrVil group ( 126 ± 29 )mins was shorter than that in Endo-GIA group ( 156 ± 28 ) mins ( P ＜ 0.05 ),but at the same time,the mean expenditure was higher. Evaluated on three months after operation,the T2DM cure rate was 78％,and effective rate was 100％ in OrVil goup and those were 83％,100％ respectively in Endo-GIA group.No postoperative malnutrition, anemia or severe complication occurred. Conclusions The efficiency of laparoscopic Roux-en-Y gastric bypass using different amastomoses was same in the treatment of type 2 diabetes mellitus.The operation time was shorter in OrVil group but the expenditure was higher.