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目的比较完全腹腔镜下远端胃癌根治术的消化道重建方式。方法回顾性分析完全腹腔镜下胃癌根治术患者85例的临床资料。其中,39例采用BillrothⅠ式(A组),46例采用BillrothⅡ式(B组)重建消化道。结果 85例手术均获得成功。两组的手术时间、术中出血量、淋巴结清扫数目、术后肛门排气时间、术后住院时间、术后早期并发症发生率及肿瘤复发转移率差异均无统计学意义(P>0.05)。B组术后的晚期并发症包括反流性胃炎和倾倒综合征发生率高于A组(P<0.05)。结论完全腹腔镜下远端胃癌根治术采用BillrothⅠ式和BillrothⅡ式重建消化道均安全可行;前者适合早期胃窦癌患者,后者适合进展期远端胃癌根治术患者。
Objective To compare the methods of digestive reconstruction of complete laparoscopic radical gastrectomy for gastric cancer. Methods The clinical data of 85 patients with radical laparoscopic radical gastrectomy were retrospectively analyzed. Among them, 39 patients with Billroth Ⅰ type (A group), 46 patients with Billroth Ⅱ type (B group) reconstruction of the digestive tract. Results 85 cases of surgery were successful. There were no significant differences in the operation time, intraoperative blood loss, the number of lymph node dissection, postoperative anal exhaust time, postoperative hospital stay, early postoperative complications and tumor recurrence and metastasis rates (P> 0.05) . The postoperative complications of group B including reflux gastritis and dumping syndrome were higher than those in group A (P <0.05). Conclusions Complete laparoscopic radical gastrectomy for distal gastric cancer using Billroth Ⅰ and Billroth Ⅱ reconstruction of the digestive tract is safe and feasible. The former is suitable for patients with early gastric cancer and the latter is suitable for advanced radical gastrectomy.