腹腔镜uncut Roux-en-Y吻合与传统吻合方式的研究进展
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摘要
随着胃癌患者术后5年生存率的提高,患者对获得更好的术后生活质量的要求也不断提高,这与手术中消化道重建的方式有关,目前腹腔镜手术的应用已被多数普外科医生接受,但消化道重建的选择方式尚未统一。传统的3种吻合方式各有其优缺点,但共同弊端是会影响患者术后的生存质量。Uncut Roux-en-Y吻合术能够阻断肠道消化液返流,同时保持完整的肠道电生理,患者术后并发症少,将可能成为最理想的消化道重建方式。现就腹腔镜uncut Roux-en-Y吻合与传统吻合方式对胃癌患者术后生活质量的影响进行综述,分析各种吻合方式的优缺点。
With the improvement of 5-year survival rate in patients with gastric carcinoma, the demand for better postoperative quality of life is also increasing, which is related to the way of digestive tract reconstruction during operation.At present,the application of laparoscopic surgery has been accepted by most general surgeons, but the choice of digestive tract reconstruction is not uniform.The traditional three anastomosis methods have their own advantages and disadvantages, but the common disadvantage is that the quality of life after operation will be affected.Uncut Roux-en-Y anastomosis can block digestive fluid regurgitation and maintain complete intestinal electrophysiology, which may be the most ideal way to reconstruct digestive tract.The effect of laparoscopic uncut Roux-enY anastomosis and traditional anastomosis on postoperative quality of life of gastric carcinoma patients was reviewed and the advantages and disadvantages of various anastomosis methods were analyzed in this article.
With the improvement of 5-year survival rate in patients with gastric carcinoma, the demand for better postoperative quality of life is also increasing, which is related to the way of digestive tract reconstruction during operation.At present,the application of laparoscopic surgery has been accepted by most general surgeons, but the choice of digestive tract reconstruction is not uniform.The traditional three anastomosis methods have their own advantages and disadvantages, but the common disadvantage is that the quality of life after operation will be affected.Uncut Roux-en-Y anastomosis can block digestive fluid regurgitation and maintain complete intestinal electrophysiology, which may be the most ideal way to reconstruct digestive tract.The effect of laparoscopic uncut Roux-enY anastomosis and traditional anastomosis on postoperative quality of life of gastric carcinoma patients was reviewed and the advantages and disadvantages of various anastomosis methods were analyzed in this article.
引文
[1]陈万青,郑荣寿,张思维,等.2013年中国老年人群恶性肿瘤发病和死亡分析[J].中华肿瘤杂志,2017,39(1):60-66.
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[6]黄昌明,李子禹,臧潞.全腹腔镜远端胃癌根治术消化道重建方式选择-Brillroth-Ⅰ式、Brillroth-Ⅱ式还是Roux-en-Y吻合?[J].中国实用外科杂志,2016(9):953-954.
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[11]杜德晓,张能维,宫轲,等.腹腔镜Roux-en-Y胃旁路术治疗不同肥胖程度2型糖尿病的疗效[J].中华普通外科杂志,2016,31(10):804-807.
[12]张顺,杜涛,严东羿,等.腹腔镜远端胃癌根治术改良非离断Roux-en-Y吻合术的临床应用体会[J].临床普外科电子杂志,2017,5(3):26-30,46.
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[14]Ahn SH,Son SY,Lee CM,et al.intracorporeal Uncut Rouxen-Y Gastrojejunostomy Reconstruction in Pure Single-incision Laparoscopic Distal Gastrectomy for Early Gastric Cancer Unaided Stapling Closure[J].Journal of the American College of Surgeons,2014,218(1):e17-e21.
[15]杨栋.腹腔镜辅助胃癌根治术后Uncut Roux-en-Y与BrillrothⅡ2种消化道重建方式反流相关并发症比较[D].吉林大学,2016.
[16]陈刚,朱奎阳,汤远银,等.空肠uncut Roux-en-Y手术在胃癌消化道重建中的应用[J].中国现代普通外科进展,2018,21(3):214-216.
[17]Park JY,Kim YJ.Uncut Roux-en-Y Reconstruction after Laparoscopic Distal Gastrectomy Can Be a Favorable Method in Terms of Gastritis,Bile Reflux,and Gastric Residue[J].Journal of Gastric Cancer,2014,14(4):229-237.
[18]申腾飞,陈文超,韩斌.根治性全胃切除术后uncut Rouxen-Y吻合的应用研究[J].中国现代医学杂志,2017,27(6):101-105.
[19]黄玉琴,史友权,汤东,等.非离断式Roux-en-Y吻合术在远端胃癌根治术后消化道重建的应用进展[J].中华消化外科杂志,2016,15(9):943-946.
[20]王胤奎,李子禹,陕飞,等.腹腔镜下非离断式Roux-en-Y与BrillrothⅡ-Braun消化道重建的安全性及卫生经济学比较--单中心前瞻性队列研究[J].中华胃肠外科杂志,2018(3):312-317.
[2]夏挺松,刘兵团,王芳军,等.术前外周血中性粒细胞和淋巴细胞比值与血小板和淋巴细胞比值评估胃癌患者淋巴结转移的价值[J].中华消化杂志,2017,37(11):765-767.
[3]Wanebo HJ,Kennedy BJ,Chmiel J,et al.Cancer of the stomach.A patient care study by the American College of Surgeons[J].Annals of Surgery,1993,218(5):583-592.
[4]Ajani JA.Evolving chemotherapy for advanced gastric cancer[J].Oncologist,2005,10(Suppl 3):49-58.
[5]刘震,刘书尚,徐光辉,等.远端胃癌患者毕Ⅰ式与毕Ⅱ式吻合术后并发症及远期生存比较[J].中华胃肠外科杂志,2016,19(7):785-788.
[6]黄昌明,李子禹,臧潞.全腹腔镜远端胃癌根治术消化道重建方式选择-Brillroth-Ⅰ式、Brillroth-Ⅱ式还是Roux-en-Y吻合?[J].中国实用外科杂志,2016(9):953-954.
[7]胡祥.远端胃切除术后的消化道重建[J].中华胃肠外科杂志2014,17(5):419-422.
[8]揭志刚.远端胃癌根治术后消化道重建方式研究现状[J].消化肿瘤杂志:电子版,2015,7(3):127-129.
[9]白洋,傅卫.Roux淤滞综合征研究现状[J].中华消化外科杂志,2015,14(7):593-597.
[10]徐正荣,郭文俊.Roux-en-Y吻合术后肠系膜性腹内疝的临床研究进展[J].中华胃肠外科杂志,2017,20(3):352-356.
[11]杜德晓,张能维,宫轲,等.腹腔镜Roux-en-Y胃旁路术治疗不同肥胖程度2型糖尿病的疗效[J].中华普通外科杂志,2016,31(10):804-807.
[12]张顺,杜涛,严东羿,等.腹腔镜远端胃癌根治术改良非离断Roux-en-Y吻合术的临床应用体会[J].临床普外科电子杂志,2017,5(3):26-30,46.
[13]Kim JJ,Song KY,Chin HM,et al.Totally laparoscopic gastrectomy with various types of intracorporeal anastomosis using laparoscopic linear staplers:preliminary experience[J].Surgica Endoscopy,2008,22(2):436-442.
[14]Ahn SH,Son SY,Lee CM,et al.intracorporeal Uncut Rouxen-Y Gastrojejunostomy Reconstruction in Pure Single-incision Laparoscopic Distal Gastrectomy for Early Gastric Cancer Unaided Stapling Closure[J].Journal of the American College of Surgeons,2014,218(1):e17-e21.
[15]杨栋.腹腔镜辅助胃癌根治术后Uncut Roux-en-Y与BrillrothⅡ2种消化道重建方式反流相关并发症比较[D].吉林大学,2016.
[16]陈刚,朱奎阳,汤远银,等.空肠uncut Roux-en-Y手术在胃癌消化道重建中的应用[J].中国现代普通外科进展,2018,21(3):214-216.
[17]Park JY,Kim YJ.Uncut Roux-en-Y Reconstruction after Laparoscopic Distal Gastrectomy Can Be a Favorable Method in Terms of Gastritis,Bile Reflux,and Gastric Residue[J].Journal of Gastric Cancer,2014,14(4):229-237.
[18]申腾飞,陈文超,韩斌.根治性全胃切除术后uncut Rouxen-Y吻合的应用研究[J].中国现代医学杂志,2017,27(6):101-105.
[19]黄玉琴,史友权,汤东,等.非离断式Roux-en-Y吻合术在远端胃癌根治术后消化道重建的应用进展[J].中华消化外科杂志,2016,15(9):943-946.
[20]王胤奎,李子禹,陕飞,等.腹腔镜下非离断式Roux-en-Y与BrillrothⅡ-Braun消化道重建的安全性及卫生经济学比较--单中心前瞻性队列研究[J].中华胃肠外科杂志,2018(3):312-317.