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近端胃癌的近端胃切除术加空肠间置及TGRY吻合术

Proximal gastrectomy with jejunal interposition and TGRY anastomosis for proximal gastric cancer.

作者信息

Zhao Ping, Xiao Shuo-Meng, Tang Ling-Chao, Ding Zhi, Zhou Xiang, Chen Xiao-Dong

机构信息

Ping Zhao, Shuo-Meng Xiao, Ling-Chao Tang, Zhi Ding, Xiang Zhou, Xiao-Dong Chen, Department of Gastro-hepatic Surgery, Sichuan Cancer Hospital, Chengdu 610041, Sichuan Province, China.

出版信息

World J Gastroenterol. 2014 Jul 7;20(25):8268-73. doi: 10.3748/wjg.v20.i25.8268.

Abstract

AIM

To compare the short-term outcomes of patients who underwent proximal gastrectomy with jejunal interposition (PGJI) with those undergoing total gastrectomy with Roux-en-Y anastomosis (TGRY).

METHODS

From January 2009 to January 2011, thirty-five patients underwent PGJI, and forty-one patients underwent TGRY. The surgical efficacy and short-term follow-up outcomes were compared between the two groups.

RESULTS

There were no differences in the demographic and clinicopathological characteristics. The mean operation duration and postoperative hospital stay in the PGJI group were statistically longer than those in the TGRY group (P = 0.00). No anastomosis leakage was observed in two groups. No statistically significant difference was found in endoscopic findings, Visick grade or serum albumin level. The single-meal food intake in the PGJI group was more than that in the TGRY group (P = 0.00). The PG group showed significantly better hemoglobin levels in the second year (P = 0.02). The two-year survival rate was not significantly different (PGJI vs TGRY, 93.55% vs 92.5%, P = 1.0).

CONCLUSION

PGJI is a safe, radical surgical method for proximal gastric cancer and leads to better outcomes in terms of the single-meal food intake and hemoglobin level, compared with TGRY in the short term.

摘要

目的

比较接受近端胃切除术加空肠间置术(PGJI)的患者与接受全胃切除术加Roux-en-Y吻合术(TGRY)的患者的短期结局。

方法

2009年1月至2011年1月,35例患者接受了PGJI,41例患者接受了TGRY。比较两组的手术疗效和短期随访结局。

结果

两组患者的人口统计学和临床病理特征无差异。PGJI组的平均手术时间和术后住院时间在统计学上长于TGRY组(P = 0.00)。两组均未观察到吻合口漏。在内镜检查结果、Visick分级或血清白蛋白水平方面未发现统计学上的显著差异。PGJI组的单次进餐食物摄入量高于TGRY组(P = 0.00)。PG组在第二年的血红蛋白水平明显更好(P = 0.02)。两年生存率无显著差异(PGJI组与TGRY组,93.55%对92.5%,P = 1.0)。

结论

PGJI是一种治疗近端胃癌的安全、根治性手术方法,与TGRY相比,短期内单次进餐食物摄入量和血红蛋白水平的结局更好。

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