摘要: |
目的:分析远端胃大部切除联合Roux-en-Y重建术后胃排空障碍(delayed gastric emptying, DGE)的相关因素。
方法:回顾性分析256例于2013年1月1日至2018年12月1日在长海医院普通外科因胃癌行远端胃大部切除术和Roux-en-Y重建的256例患者的临床资料,包括性别、年龄、体质指数(BMI)、个人史、家族史、临床症状、病变部位、组织学分化程度、TNM分期、手术方式。
结果:256例患者中,28例出现术后DGE。糖尿病患者DGE的发生率明显高于非糖尿病患者(P<0.05);肿瘤位于胃下1/3患者DGE的发生率高于肿瘤位于胃中1/3的患者(P<0.05);临床Ⅲ+Ⅳ期患者DGE的发生率高于Ⅰ+Ⅱ期患者(P<0.05)。DGE与患者的性别、年龄、烟酒史、心肺疾病、BMI、肿瘤大小、TNM分期、淋巴结转移、手术方式、手术时间、术中出血量及术中是否输血无相关性。
结论:糖尿病、肿瘤位于胃下1/3、Ⅲ+Ⅳ期是远端胃癌患者远端胃大部切除联合Roux-en-Y吻合术后发生DGE的相关危险因素。 |
关键词: 胃癌 胃排空障碍 胃切除术 |
DOI: |
分类号:R 735.2 |
基金项目:上海市科学技术委员会自然基金面上项目(17ZR1438400),上海市卫生和计划生育委员会科研课题重点项目(201640017). |
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Predictive factors for delayed gastric emptying after distal gastrectomy with Roux-en-Y reconstruction |
BAI Bin△, CAI Hui△, NIE Ming-ming, MA Li-ye, YIN Kai*
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Department of General Surgery, Changhai Hospital, Navy Military Medical University, Shanghai 200433, China
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Abstract: |
Objective:To evaluate the risk factors of delayed gastric emptying (DGE) after distal gastrectomy with Roux-en-Y reconstruction.
Methods:Clinicopathological data of 256 patients admitted at Changhai Hospital and received distal gastrectomy with Roux-en-Y reconstruction from January 2013 to December 2018 were retrospectively analyzed. The statistical analysis were conducted to evaluate gender, age, body mass index (BMI), personal history, family history, clinical symptoms, tumor location, histologic differentiation degree, TNM stages, and surgical approach.
Results:DGE occurred in 28 of the 256 patients. The DGE incidence in patients with diabetes mellitus was higher than patients without diabetes mellitus (P<0.05). The DGE incidence in patients with tumor located in the lower third of the stomach was higher than patients with tumor located in the middle part of the stomach (P<0.05). The DGE incidence in clinical Ⅲ+Ⅳ stage patients was higher than clinical Ⅰ+Ⅱ stage patients (P<0.05). There were no correlations of gender, age, smoking history, drinking history, cardiopulmonary diseases, BMI, TNM stages, lymph node metastasis, surgical approach, operation time, blood loss and transfusion in operation with DGE development.
Conclusions:Combined with diabetes mellitus, clinical Ⅲ+Ⅳ stage, and tumor located in the lower third of the stomach may be risk factors of DGE in distal gastrectomy patients after R-Y reconstruction. |
Key words: gastric carcinoma delayed gastric emptying gastrectomy |