Department of General Surgery, Taizhou First People's Hospital, Taizhou 318020, China.
J Healthc Eng. 2022 Mar 23;2022:8281558. doi: 10.1155/2022/8281558. eCollection 2022.
The aim of this study was to investigate the effects of double-channel anastomosis versus esophagojejunostomy on postoperative recovery and complications after laparoscopic D2 radical gastrectomy for early proximal gastric cancer. The cases were collected from 100 patients with early proximal gastric cancer admitted to our hospital from January 2017 to January 2021. According to different surgical methods, they were divided into control group (total gastrectomy + esophagojejunal anastomosis) and experimental group (D2 radical resection + double-channel anastomosis). The two groups were compared in terms of clinical outcomes (operative time, intraoperative blood loss, number of lymph nodes dissected, digestive tract anastomosis time, postoperative exhaust, and hospitalization days), postoperative complications, and nutritional status; the expression of T lymphocyte subsets in peripheral blood of the two groups was detected to reflect the recovery of immune ability. There was no significant difference between the observation group and the control group in clinical operation effect indexes ( < 0.05). The incidence of complications of dumping syndrome and reflux esophagitis in the observation group was significantly lower than that in the control group ( < 0.05). In terms of postoperative nutritional status, the ratio of plasma albumin level and body weight restored to operation at 12 and 24 weeks after operation in the observation group was significantly higher than that in the control group ( < 0.05). 3 months after the operation, the levels of CD3 +, CD4 + cell subsets, and CD4+/CD8+ index reflecting the recovery of immune ability in the observation group were significantly higher than those in the observation group ( < 0.05). The application of double-channel anastomosis in laparoscopic D2 radical gastrectomy for early proximal gastric cancer has a better effect on reducing complications and promoting postoperative recovery, which is of great application value.
本研究旨在探讨双通道吻合术与食管空肠吻合术对腹腔镜 D2 根治性胃切除术治疗早期近端胃癌术后恢复和并发症的影响。该研究共纳入了 2017 年 1 月至 2021 年 1 月期间在我院接受治疗的 100 例早期近端胃癌患者。根据不同的手术方法，将患者分为对照组（全胃切除术+食管空肠吻合术）和实验组（D2 根治性切除术+双通道吻合术）。比较两组患者的临床结局（手术时间、术中出血量、清扫淋巴结数量、消化道吻合时间、术后排气时间和住院天数）、术后并发症和营养状况；检测两组患者外周血 T 淋巴细胞亚群的表达，以反映免疫能力的恢复情况。观察组与对照组在临床手术效果指标方面无显著差异（>0.05）。观察组的倾倒综合征和反流性食管炎并发症发生率明显低于对照组（<0.05）。在术后营养状况方面，观察组术后 12 周和 24 周时血浆白蛋白水平和体重恢复到手术前的比例明显高于对照组（<0.05）。术后 3 个月，观察组反映免疫能力恢复的 CD3+、CD4+细胞亚群和 CD4+/CD8+指数水平明显高于对照组（<0.05）。双通道吻合术在腹腔镜 D2 根治性胃切除术治疗早期近端胃癌中具有降低并发症和促进术后恢复的更好效果，具有重要的应用价值。
