全腹腔镜远端胃切除术后 Roux-en-Y 胃空肠吻合术：与毕罗Ⅱ式重建的比较
Roux-en-Y gastrojejunostomy after totally laparoscopic distal gastrectomy: comparison with Billorth II reconstruction.
作者信息
Shim Jung Ho, Oh Seong Il, Yoo Han Mo, Jeon Hae Myung, Park Cho Hyun, Song Kyo Young
机构信息
Department of Surgery, Division of Gastrointestinal Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea.
出版信息
Surg Laparosc Endosc Percutan Tech. 2014 Oct;24(5):448-51. doi: 10.1097/SLE.0b013e31829014ea.
PURPOSE
The purpose of this study was to compare Roux-en-Y (R-Y) reconstruction with Billroth-II (B-II) reconstruction after a totally laparoscopic distal gastrectomy (TLDG).
METHODS
Eighty-one consecutive TLDG procedures were performed by a single surgeon and subsequently examined. Postoperative outcomes, clinicopathologic features, and postoperative endoscopic findings between the 2 groups were evaluated and compared.
RESULTS
The mean operation time was not significantly higher in the R-Y than in the B-II group (P=0.396). Postoperative hospital stay was longer in the R-Y than in the B-II group (P=0.037). The severities of gastritis and bile reflux were reduced significantly in the R-Y group as compared with that in the B-II group (P<0.001). There was no significant difference in the amount of residual food between the 2 groups.
CONCLUSIONS
R-Y reconstruction after TLDG appears to be a safe and feasible procedure, and is associated with a reduced severity of gastritis and bile reflux in the remnant stomach.
目的
本研究旨在比较完全腹腔镜远端胃切除术（TLDG）后Roux-en-Y（R-Y）重建与毕罗Ⅱ式（B-II）重建的效果。
方法
由一名外科医生连续进行81例TLDG手术，随后进行检查。评估并比较两组的术后结果、临床病理特征及术后内镜检查结果。
结果
R-Y组的平均手术时间并不显著高于B-II组（P = 0.396）。R-Y组的术后住院时间长于B-II组（P = 0.037）。与B-II组相比，R-Y组胃炎和胆汁反流的严重程度显著降低（P < 0.001）。两组之间的残留食物量无显著差异。
结论
TLDG术后的R-Y重建似乎是一种安全可行的手术方式，且与残胃胃炎和胆汁反流严重程度降低有关。
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