CAJ | 학술논문

目的：对比分析远端胃癌根治术中全腹腔镜下三角吻合与腹腔镜辅助 Brillroth I 式吻合的近期效果。方法纳入2012年2月至2014年10月接受诊治的远端胃癌患者86例。根据随机数字表法将其随机分为 A 组（n ＝43）和 B 组（n ＝43）。A 组采用腹腔镜辅助 Brillroth I 式吻合术，B 组采用全腹腔镜下三角吻合术。观察两组手术时间、住院时间、术中出血量、术后排气时间、拆线时间、淋巴结清扫数目、术后并发症及死亡情况。结果 A 组手术时间明显短于B 组（ P ﹤0.05）；A 组和 B 组术后住院时间比较无统计学意义（ P ﹥0.05）；B 组术中出血量明显少于 A 组（ P ﹤0.05）；术后排气时间、拆线时间均明显短于 A 组，淋巴结清扫数目明显多于 A 组（ P ﹤0.05）；两组术后并发症发生率比较差异无统计学意义（ P ﹥0.05）；两组均未出现死亡情况。结论远端胃癌根治术中全腹腔镜下三角吻合近期效果明显优于腹腔镜辅助 Brillroth I 式吻合，但手术时间长于腹腔镜辅助 Brillroth I 式吻合，临床上可根据患者特点选用适合的根治术，可优先考虑全腹腔镜下三角吻合术。
목적：대비분석원단위암근치술중전복강경하삼각문합여복강경보조 Brillroth I 식문합적근기효과。방법납입2012년2월지2014년10월접수진치적원단위암환자86례。근거수궤수자표법장기수궤분위 A 조（n ＝43）화 B 조（n ＝43）。A 조채용복강경보조 Brillroth I 식문합술，B 조채용전복강경하삼각문합술。관찰량조수술시간、주원시간、술중출혈량、술후배기시간、탁선시간、림파결청소수목、술후병발증급사망정황。결과 A 조수술시간명현단우B 조（ P ﹤0.05）；A 조화 B 조술후주원시간비교무통계학의의（ P ﹥0.05）；B 조술중출혈량명현소우 A 조（ P ﹤0.05）；술후배기시간、탁선시간균명현단우 A 조，림파결청소수목명현다우 A 조（ P ﹤0.05）；량조술후병발증발생솔비교차이무통계학의의（ P ﹥0.05）；량조균미출현사망정황。결론원단위암근치술중전복강경하삼각문합근기효과명현우우복강경보조 Brillroth I 식문합，단수술시간장우복강경보조 Brillroth I 식문합，림상상가근거환자특점선용괄합적근치술，가우선고필전복강경하삼각문합술。
Objective To compare the short - term effect of totally laparoscopic delta - shaped anastomosis with laparoscopic - assisted Brillroth I anastomosis in radical distal gastrectomy for gastric cancer. Methods Based on the random number table,86 distal gastric cancer pa-tients treated from February 2012 to October 2014 were randomly divided into group A(n = 43)and group B(n = 43). For the radical distal gas-trectomy,patients in group A received laparoscopic - assisted Brillroth I anastomosis,group B received totally laparoscopic delta - shaped anasto-mosis. Operation time,hospitalization time,blood loss,the time to first flatus,removing stitches time,number of lymph node dissection,postop-erative complications were observed between two groups. Results Operation time in group A was significantly shorter than group B( P ﹤ 0. 05). Less blood loss,shorter time to first flatus and removing stitches time were observed in group B than group A( P ﹤ 0. 05). The number of lymph node dissected in group B was more than group A( P ﹤ 0. 05). No significant difference was found in postoperative hospital stay and complica-tions between two groups( P ﹥ 0. 05). No patients died during the study. Conclusion Except operation time,totally laparoscopic distal gastrec-tomy with delta - shaped anastomosis shows better short - term efficacy than laparoscopic - assisted distal gastrectomy with Brillroth I anastomosis.