PDF(Pubmed)
Abstract：
BACKGROUND: To compare short-term and long-term clinical effects of modified overlap anastomosis and conventional incision-assisted anastomosis for laparoscopic total gastrectomy.
METHODS: This retrospective cohort study included patients with gastric cancer admitted to the Second Affiliated Hospital of Fujian Medical University from January 2016 to March 2020. Quality of life, intraoperative and postoperative conditions were analyzed.
RESULTS: Compared with the conventional assisted group, the modified overlap group showed a shorter auxiliary incision, milder postoperative pain, shorter time to the first postoperative anal exhaust, shorter time to the first postoperative liquid food intake, and shorter postoperative stay. There were no differences between the two groups regarding operation time, esophagus-jejunum anastomosis time, intraoperative blood loss, number of lymph nodes dissected, and length of the upper incision margin. There were no differences between the two groups regarding postoperative early and late complications. There were no differences between the two groups regarding the QLQ-C30 scale three years after the operation. The scores of the QLQ-STO22 scale 3 years after the operation showed significantly lower scores for dysphagia and feeding limit in the modified overlap group than those in the conventional assisted anastomosis group. There was no recurrence in the modified overlap group but one patient in the conventional assisted group.
CONCLUSIONS: Patients undergoing totally laparoscopic total gastrectomy with modified overlap anastomosis have better minimal invasiveness and faster post-operative recovery than conventional incision-assisted anastomosis.
METHODS: This retrospective cohort study included patients with gastric cancer admitted to the Second Affiliated Hospital of Fujian Medical University from January 2016 to March 2020. Quality of life, intraoperative and postoperative conditions were analyzed.
RESULTS: Compared with the conventional assisted group, the modified overlap group showed a shorter auxiliary incision, milder postoperative pain, shorter time to the first postoperative anal exhaust, shorter time to the first postoperative liquid food intake, and shorter postoperative stay. There were no differences between the two groups regarding operation time, esophagus-jejunum anastomosis time, intraoperative blood loss, number of lymph nodes dissected, and length of the upper incision margin. There were no differences between the two groups regarding postoperative early and late complications. There were no differences between the two groups regarding the QLQ-C30 scale three years after the operation. The scores of the QLQ-STO22 scale 3 years after the operation showed significantly lower scores for dysphagia and feeding limit in the modified overlap group than those in the conventional assisted anastomosis group. There was no recurrence in the modified overlap group but one patient in the conventional assisted group.
CONCLUSIONS: Patients undergoing totally laparoscopic total gastrectomy with modified overlap anastomosis have better minimal invasiveness and faster post-operative recovery than conventional incision-assisted anastomosis.
摘要：
背景：比较改良式重叠吻合术与传统切口辅助吻合术在腹腔镜全胃切除术中的近期和远期临床效果。
方法：本回顾性队列研究纳入2016年1月至2020年3月福建医科大学附属第二医院收治的胃癌患者。生活质量,术中及术后情况进行分析。
结果：与常规辅助组相比，改良重叠组显示较短的辅助切口，术后疼痛较轻，术后第一次肛门排气的时间较短，术后第一次摄入液体食物的时间较短，术后住院时间较短。两组手术时间无差异。食管-空肠吻合时间,术中失血,解剖的淋巴结数量，和上切口边缘的长度。两组术后早期和晚期并发症无差异。两组术后3年QLQ-C30量表无差异。术后3年的QLQ-STO22量表评分显示，改良重叠组的吞咽困难和进食限制评分明显低于常规辅助吻合组。改良重叠组无复发，常规辅助组有1例复发。
结论：完全腹腔镜全胃切除术合并改良重叠吻合术的患者比传统切口辅助吻合术具有更好的微创和更快的术后恢复。
方法：本回顾性队列研究纳入2016年1月至2020年3月福建医科大学附属第二医院收治的胃癌患者。生活质量,术中及术后情况进行分析。
结果：与常规辅助组相比，改良重叠组显示较短的辅助切口，术后疼痛较轻，术后第一次肛门排气的时间较短，术后第一次摄入液体食物的时间较短，术后住院时间较短。两组手术时间无差异。食管-空肠吻合时间,术中失血,解剖的淋巴结数量，和上切口边缘的长度。两组术后早期和晚期并发症无差异。两组术后3年QLQ-C30量表无差异。术后3年的QLQ-STO22量表评分显示，改良重叠组的吞咽困难和进食限制评分明显低于常规辅助吻合组。改良重叠组无复发，常规辅助组有1例复发。
结论：完全腹腔镜全胃切除术合并改良重叠吻合术的患者比传统切口辅助吻合术具有更好的微创和更快的术后恢复。
