Wang Mian, Zhang Li-Li, Wang Gang, Miao Yong-Chang, Zhang Tao, Qiu Lei, Fang Gui-Da, Lu Feng, Xu Da-Lai, Yu Peng
Department of Nail and Breast Surgery, The Second People's Hospital of Lianyungang, Lianyungang 222000, Jiangsu Province, China.
Department of Emergency Medicine, Lianyungang Second People's Hospital, Lianyungang 222000, Jiangsu Province, China.
World J Gastrointest Surg. 2025 Jan 27;17(1):101204. doi: 10.4240/wjgs.v17.i1.101204.
According to statistics, the incidence of proximal gastric cancer has gradually increased in recent years, posing a serious threat to human health. Tubular gastroesophageal anastomosis and double-channel anastomosis are two relatively mature anti-reflux procedures. A comparison of these two surgical procedures, tubular gastroesophageal anastomosis and double-channel anastomosis, has rarely been reported. Therefore, this study aimed to investigate the effects of these two reconstruction methods on the quality of life of patients with proximal gastric cancer after proximal gastrectomy.
To compare short-term clinical results of laparoscopic proximal gastrectomy with double-channel anastomosis tubular gastric anastomosis.
Patients who underwent proximal gastrectomy at our hospital between January 2020 and January 2023 were enrolled in this retrospective cohort study. The patients were divided into an experimental group (double-channel anastomosis, 33 cases) and a control group (tubular gastric anastomosis, 30 cases). Baseline characteristics, surgical data, postoperative morbidities, and postoperative nutrition were recorded.
The differences in baseline data, surgical data, and postoperative complications (20.0% 21.2%) were not statistically significant between the two groups. There were no statistically significant differences in the levels of postoperative nutrition indicators between the two groups of patients during the preoperative period and at 3 months postoperatively. In addition, the levels of postoperative nutrition indicators in patients in the experimental group declined significantly less at 6 months and 12 months postoperatively compared with those of the control group ( < 0.05). At 12 months postoperatively, the difference in anastomotic reflux esophagitis between the two groups was statistically significant ( < 0.05) with the experimental group showing less reflux esophagitis.
Both double-channel anastomosis and tubular gastric anastomosis after proximal gastrectomy are safe and feasible. Double-channel anastomosis has a better anti-reflux effect and is more beneficial in improving the postoperative nutritional status.
据统计，近年来近端胃癌的发病率逐渐上升，对人类健康构成严重威胁。管状胃食管吻合术和双通道吻合术是两种相对成熟的抗反流手术。这两种手术方式（管状胃食管吻合术和双通道吻合术）的比较鲜有报道。因此，本研究旨在探讨这两种重建方法对近端胃癌患者近端胃切除术后生活质量的影响。
比较腹腔镜近端胃切除术采用双通道吻合术与管状胃吻合术的短期临床效果。
选取2020年1月至2023年1月在我院接受近端胃切除术的患者纳入本回顾性队列研究。将患者分为实验组（双通道吻合术，33例）和对照组（管状胃吻合术，30例）。记录基线特征、手术数据、术后发病率及术后营养情况。
两组间基线数据、手术数据及术后并发症（20.0%对21.2%）差异无统计学意义。两组患者术前及术后3个月时术后营养指标水平差异无统计学意义。此外，实验组患者术后6个月和12个月时术后营养指标水平较对照组下降明显更少（P<0.05）。术后12个月时，两组间吻合口反流性食管炎差异有统计学意义（P<0.05），实验组反流性食管炎较少。
近端胃切除术后双通道吻合术和管状胃吻合术均安全可行。双通道吻合术具有更好的抗反流效果，更有利于改善术后营养状况。
