【摘要】 目的分析腹腔镜辅助下近端胃切除自带抗反流装置管型胃在SiewertⅡ型和Ⅲ型食管胃结合部腺癌(AEG)中临床疗效。方法回顾性分析2017年6月至2019年6月59例行腹腔镜辅助下近端胃切除的SiewertⅡ型和Ⅲ型AEG患者临床资料。其中2018年7月之前30例行传统管型胃食管吻合(A组),2018年7月及以后29例行自带抗反流装置管型胃食管吻合(B组)。应用SPSS 19.0统计软件进行分析,围术期指标及RDQ评分等计量资料以■表示,采用独立t检验;术后胃食管反流症状、反流性食管炎(RE)、胃食管反流病(GERD)等计数指标比较采用χ~2检验,P<0.05为差异有统计学意义。结果两组患者在术后胃食管反流症状、RE及GERD发生率比较上差异无统计学意义(P>0.05);两组术后3个月、6个月RDQ评分分别为(8.83±4.00)分比(4.28±3.16)分、(8.60±4.09)分比(4.83±3.04)分,A组明显高于B组,差异有统计学意义(P<0.05)。结论自带抗反流装置管型胃食管吻合较传统管型胃食管吻合具有更好抗术后反流的疗效,且费用相对低、操作简单安全,值得临床推广。更多还原

【Abstract】 Objective To analyze the clinical efficacy of laparoscopy-assisted proximal gastrectomy with anti-reflux gastric tube reconstruction for patients with Siewert type II and III adenocarcinoma of esophagogastric junction (AEG).Methods The clinical data of 59 patients with Siewert type II and III AEG,who underwent laparoscopy-assisted proximal gastrectomy from June 2017 to June 2019,was analyzed retrospectively.Among these patients,30 patients in group A received traditional gastric tube reconstruction before July 2018,while 29 patients in group B underwent anti-reflux gastric tube reconstruction from June2018 to June 2019.Statistical analysis were performed by using SPSS 19.0 software.Measurement data such as perioperative indicators and RDQ scores were expressed as (■±s),and were examined by using independent t test.Postoperative gastroesophageal reflux symptoms,reflux esophagitis (RE),gastroesophageal reflux disease (GERD) and other count data were analyzed by usingχ~2test.A P value of<0.05 was considered as statistically significant difference.Results There was no statistically significant difference in the incidence of gastroesophageal reflux symptoms,RE and GERD between the two groups(P>0.05).The RDQ score of group A were significantly higher than that of group B 3 months and 6months after the operation[(8.83±4.00) vs.(4.28±3.16),P<0.05],[(8.60±4.09) vs.(4.83±3.04),P<0.05].Conclusion Compared with the traditional gastric tube reconstruction,anti-reflux management could achieve better clinical outcome,with less medical cost and simple and safe operative procedures,which is worthy of clinical promotion.更多还原