Zhang G Y, Cao Y, Feng Z F, Wang G S, Li Z R
Department of digestive surgery,digestive disease hospital, the First Affiliated Hospital of Nanchang University; Department of general surgery, the First Affiliated Hospital of Nanchang University, Nanchang 330006, China.
Zhonghua Wei Chang Wai Ke Za Zhi. 2023 Feb 25;26(2):175-180. doi: 10.3760/cma.j.cn441530-20220928-00395.
To assess the effect of jejunal feeding tube placement on early complications of laparoscopic radical gastrectomy in patients with incomplete pyloric obstruction by gastric cancer. This was a retrospective cohort study. Perioperative clinical data of 151 patients with gastric antrum cancer complicated by incomplete pyloric obstruction who had undergone laparoscopic distal radical gastrectomy from May 2020 to May 2022 in the First Affiliated Hospital of Nanchang University were collected. Intraoperative jejunal feeding tubes had been inserted in 69 patients (nutrition tube group) and not in the remaining 82 patients (conventional group). There were no statistically significant differences in baseline characteristics between the two groups (all >0.05). The operating time, intraoperative bleeding, time to first intake of solid food, time to passing first flatus, time to drainage tube removal, and postoperative hospital stay, and early postoperative complications (occurded within 30 days after surgery) were compared between the two groups. Patients in both groups completed the surgery successfully and there were no deaths in the perioperative period. The operative time was longer in the nutritional tube group than in the conventional group [(209.2±4.7) minutes vs. (188.5±5.7) minutes, =2.737, =0.007], whereas the time to first postoperative intake of food [(2.7±0.1) days vs. (4.1±0.4) days, =3.535, <0.001], time to passing first flatus [(2.3±0.1) days vs. (2.8±0.1) days, =3.999, <0.001], time to drainage tube removal [(6.3±0.2) days vs. (6.9±0.2) days, =2.123, =0.035], and postoperative hospital stay [(7.8±0.2) days vs. (9.7±0.5) days, =3.282, =0.001] were shorter in the nutritional tube group than in the conventional group. There was no significant difference between the two groups in intraoperative bleeding [(101.1±9.0) mL vs. (111.4±8.7) mL, =0.826, =0.410]. The overall incidence of short-term postoperative complications was 16.6% (25/151). Postoperative complications did not differ significantly between the two groups (all >0.05). It is safe and feasible to insert a jejunal feeding tube in patients with incomplete outlet obstruction by gastric antrum cancer during laparoscopic radical gastrectomy. Such tubes confer some advantages in postoperative recovery.
评估空肠营养管置入对胃癌致不完全性幽门梗阻患者腹腔镜根治性胃切除术后早期并发症的影响。这是一项回顾性队列研究。收集了2020年5月至2022年5月在南昌大学第一附属医院接受腹腔镜远端根治性胃切除术的151例胃窦癌合并不完全性幽门梗阻患者的围手术期临床资料。69例患者术中插入了空肠营养管（营养管组），其余82例未插入（常规组）。两组患者的基线特征差异无统计学意义（均>0.05）。比较了两组患者的手术时间、术中出血量、首次进食固体食物时间、首次排气时间、引流管拔除时间、术后住院时间以及术后早期并发症（术后30天内发生）。两组患者均成功完成手术，围手术期无死亡病例。营养管组的手术时间长于常规组[（209.2±4.7）分钟 vs.（188.5±5.7）分钟，t=2.737，P=0.007]，而营养管组术后首次进食时间[（2.7±0.1）天 vs.（4.1±0.4）天，t=3.535，P<0.001]、首次排气时间[（2.3±0.1）天 vs.（2.8±0.1）天，t=3.999，P<0.001]、引流管拔除时间[（6.3±0.2）天 vs.（6.9±0.2）天，t=2.123，P=0.035]和术后住院时间[（7.8±0.2）天 vs.（9.7±0.5）天，t=3.282，P=0.001]均短于常规组。两组患者术中出血量差异无统计学意义[（101.1±9.0）mL vs.（111.4±8.7）mL，t=0.826，P=0.410]。术后短期并发症总发生率为16.6%（25/151）。两组患者术后并发症差异无统计学意义（均>0.05）。对于胃窦癌致不完全性出口梗阻患者，在腹腔镜根治性胃切除术中插入空肠营养管是安全可行的。此类营养管在术后恢复方面具有一定优势。
