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无鼻胃管及营养管置入的全胃切除术的安全性

Safety of total gastrectomy without nasogastric and nutritional intubation.

作者信息

Zhang Hong-Wei, Sun Li, Yang Xue-Wen, Feng Fan, Li Guo-Cai

机构信息

First Department of Digestive Surgery, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an, Shaanxi 710032, P.R. China.

出版信息

Mol Clin Oncol. 2017 Sep;7(3):421-426. doi: 10.3892/mco.2017.1331. Epub 2017 Jul 19.

Abstract

The aim of the present study was to evaluate the safety of gastrectomy without nasogastric and nutritional intubations. Between January 2010 and August 2015, 74 patients with gastric cancer received total gastric resection and esophagogastric anastomosis without nasogastric and nutritional intubations at the First Department of Digestive Surgery of the XiJing Hospital of Digestive Diseases (Xi'an, China), of whom 42 were also received earlier oral feeding within 48 h. The data were retrospectively analyzed. An additional 301 cases who underwent traditional postoperative intubation were used for comparison. In patients without intubation compared with those managed traditionally with intubation, the mean operative time was decreased (190.97±38.18 vs. 216.12±59.52 min, respectively; P=0.026). In addition, the postoperative activity was resumed earlier (1.16±0.47 vs. 1.36±0.84 days, respectively; P=0.009), oral food intake was started earlier (4.28±1.79 vs. 5.71±2.66 days, respectively; P=0.009), the incidence of fever was lower (12.16 vs. 29.23%, respectively; P=0.003), and the incidence of total complications was not statistically significantly different between the two groups (9.41 vs. 6.31%, respectively; P=0.317). There were no significant differences regarding complications of the anastomotic port (1.37 vs. 1.69%, respectively; P=0.849). Compared with traditional postoperative management, earlier oral feeding did not increase the incidence of complications (7.21 vs. 4.76%, respectively; P=0.557). Our results suggest that total gastric resection without nasogastric and nutritional intubation is a safe and feasible option for patients undergoing total gastrectomy.

摘要

本研究的目的是评估无鼻胃管及营养管置入的胃切除术的安全性。2010年1月至2015年8月期间,西京消化病医院第一消化外科(中国西安)74例胃癌患者接受了全胃切除术及食管胃吻合术,且未置入鼻胃管及营养管,其中42例患者在48小时内较早开始经口进食。对数据进行回顾性分析。另外选取301例行传统术后插管的病例作为对照。与传统插管管理的患者相比,未插管患者的平均手术时间缩短(分别为190.97±38.18分钟和216.12±59.52分钟;P = 0.026)。此外,术后活动恢复更早(分别为1.16±0.47天和1.36±0.84天;P = 0.009),经口进食开始更早(分别为4.28±1.79天和5.71±2.66天;P = 0.009),发热发生率更低(分别为12.16%和29.23%;P = 0.003),两组总并发症发生率无统计学显著差异(分别为9.41%和6.31%;P = 0.317)。吻合口并发症方面无显著差异(分别为1.37%和1.69%;P = 0.849)。与传统术后管理相比,较早经口进食并未增加并发症发生率(分别为7.21%和4.76%;P = 0.557)。我们的结果表明,对于接受全胃切除术的患者,无鼻胃管及营养管置入的全胃切除术是一种安全可行的选择。

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