Gastric Cancer:腹腔镜保留幽门胃切除术是术后胃淤滞的危险因素

2020-07-04 MedSci原创 MedSci原创

保留幽门的胃切除术是位于胃中部的胃癌的一种手术方式,目前已通过腹腔镜方法(LPPG)进行。PPG有时在术后早期病程中伴有关键问题,即胃瘀滞,因此本项研究旨在探究此手术方式是否是导致胃瘀滞的危险因素。

背景

保留幽门的胃切除术(PPG)是位于胃中部的胃癌的一种手术方式,目前已通过腹腔镜方法(LPPG)进行。PPG有时在术后早期病程中伴有关键问题,即胃瘀滞,因此本项研究旨在探究此手术方式是否是导致胃瘀滞的危险因素。

 

方法

该研究包括897例在2005年至2017年间接受LPPG的患者。当满足以下条件时,即定义了术后早期胃淤滞(E淤滞):上腹胀,X线摄片上剩余的胃部充盈以及饥饿时间在72小时内超过72 h术后1个月。为了评估E淤滞的长期结局,根据术后1年的RGB(残留,胃炎,胆汁)分类,将术后晚期残留食物(L-残留)在内窥镜下定义为2级或更高残留食物。

 

结果

胃瘀滞是术后早期过程中最常见的并发症。68名(7.6%)患者发生了淤滞。多因素分析确定年龄(≥61岁),糖尿病和术后腹腔内感染为危险因素。术后1年,经历淤滞的患者的相对体重比和术后血清白蛋白显着低于其他患者(P = 0.042和0.011)。在患有瘀滞的患者中,有42.5%的患者经历了L-残留。

 

结论

7.6%的患者发生LPPG后出现淤滞。年龄,糖尿病和腹腔内感染与术后胃瘀滞显着相关。

原始出处:

Ryo Takahashi. Et al. Risk factors and prognosis of gastric stasis, a crucial problem after laparoscopic pylorus-preserving gastrectomy for early middle-third gastric cancer. Gastric Cancer.2020.

 

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    2021-01-18 skhzy
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    2020-12-12 许安
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    2020-07-06 bshuang

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