Abstract：
OBJECTIVE: The aim of this study was to compare the early clinical outcomes of laparoscopic-assisted proximal gastrectomy with continuous interposition of jejunal cis-peristaltic dual-channel anastomosis and esophagogastric anastomosis.
METHODS: A retrospective analysis of 130 patients who underwent laparoscopic-assisted radical resection of proximal gastric cancer in the Department of Gastrointestinal Surgery at the Affiliated Hospital of Chengde Medical College between June 2018 and October 2022 was conducted. Continuous interposition jejunal double-channel anastomosis (double-tract anastomosis) was used in 71 patients and esophagogastric anastomosis (esophagogastrostomy) in 59 patients. The basic clinical data, preoperative and postoperative clinical test indexes, postoperative complications and improvement of symptoms compared to preoperative ones, basic nutritional status and Visick classification of esophageal reflux symptoms at 6 months after surgery were compared between the two groups. Postoperative contrast images of patients in the continuous interposition jejunal double-tract group were collected and analyzed for the ratio of contrast agent remaining in the stomach to that remaining in the small intestinal channel.
RESULTS: A total of 130 cases meeting the criteria were included in this study, including 71 cases involving the double-tract (DT) anastomosis method and 59 cases involving the esophagogastrostomy (EG) anastomosis method. There was no significant difference in preoperative information and perioperative safety between the two groups. Visick score of the DT group was significantly better than that of the EG group.
CONCLUSIONS: Double-tract jejunal anastomosis can effectively improve esophageal reflux symptoms after proximal gastrectomy. At the same time, its anastomotic method also improves the nutritional status in the short term compared to the esophagogastric anastomosis and is a more ideal procedure for reconstructing the digestive tract after proximal gastrectomy.
METHODS: A retrospective analysis of 130 patients who underwent laparoscopic-assisted radical resection of proximal gastric cancer in the Department of Gastrointestinal Surgery at the Affiliated Hospital of Chengde Medical College between June 2018 and October 2022 was conducted. Continuous interposition jejunal double-channel anastomosis (double-tract anastomosis) was used in 71 patients and esophagogastric anastomosis (esophagogastrostomy) in 59 patients. The basic clinical data, preoperative and postoperative clinical test indexes, postoperative complications and improvement of symptoms compared to preoperative ones, basic nutritional status and Visick classification of esophageal reflux symptoms at 6 months after surgery were compared between the two groups. Postoperative contrast images of patients in the continuous interposition jejunal double-tract group were collected and analyzed for the ratio of contrast agent remaining in the stomach to that remaining in the small intestinal channel.
RESULTS: A total of 130 cases meeting the criteria were included in this study, including 71 cases involving the double-tract (DT) anastomosis method and 59 cases involving the esophagogastrostomy (EG) anastomosis method. There was no significant difference in preoperative information and perioperative safety between the two groups. Visick score of the DT group was significantly better than that of the EG group.
CONCLUSIONS: Double-tract jejunal anastomosis can effectively improve esophageal reflux symptoms after proximal gastrectomy. At the same time, its anastomotic method also improves the nutritional status in the short term compared to the esophagogastric anastomosis and is a more ideal procedure for reconstructing the digestive tract after proximal gastrectomy.
摘要：
目的：本研究的目的是比较腹腔镜辅助近端胃切除术与空肠顺式-蠕动双通道吻合术和食管胃吻合术的早期临床效果。
方法：回顾性分析2018年6月至2022年10月在承德医学院附属医院胃肠外科行腹腔镜辅助近端胃癌根治术的130例患者。连续间置空肠双通道吻合术（双道吻合术）71例，食管胃吻合术（食管胃吻合术）59例。基本临床资料,术前、术后临床检验指标,与术前相比，术后并发症和症状改善，比较两组患者术后6个月的基本营养状况和食管反流症状Visick分级。收集连续插入空肠双道组患者的术后造影图像，并分析胃中残留的造影剂与小肠通道中残留的造影剂的比例。
结果：本研究共纳入130例符合标准的病例，其中涉及双道(DT)吻合术71例,涉及食管胃吻合术(EG)59例。两组术前资料及围手术期平安性无显著差别。DT组的Visick评分明显优于EG组。
结论：双道空肠吻合术能有效改善近端胃切除术后食管反流症状。同时,与食管胃吻合术相比，其吻合方法还可以在短期内改善营养状况，并且是近端胃切除术后重建消化道的更理想方法。
方法：回顾性分析2018年6月至2022年10月在承德医学院附属医院胃肠外科行腹腔镜辅助近端胃癌根治术的130例患者。连续间置空肠双通道吻合术（双道吻合术）71例，食管胃吻合术（食管胃吻合术）59例。基本临床资料,术前、术后临床检验指标,与术前相比，术后并发症和症状改善，比较两组患者术后6个月的基本营养状况和食管反流症状Visick分级。收集连续插入空肠双道组患者的术后造影图像，并分析胃中残留的造影剂与小肠通道中残留的造影剂的比例。
结果：本研究共纳入130例符合标准的病例，其中涉及双道(DT)吻合术71例,涉及食管胃吻合术(EG)59例。两组术前资料及围手术期平安性无显著差别。DT组的Visick评分明显优于EG组。
结论：双道空肠吻合术能有效改善近端胃切除术后食管反流症状。同时,与食管胃吻合术相比，其吻合方法还可以在短期内改善营养状况，并且是近端胃切除术后重建消化道的更理想方法。
