Title: Comparative Study of the Digestive Tract Reconstruction Methods after Proximal Gastrectomy
Abstract: Objective: To analyze the advantages and disadvantages of different digestive tract reconstruction methods in proximal gastrectomy for gastric carcinoma. Method: 60 patients with gastric carcinoma who hospitalized in our hospital from April 2010 to April 2012 were randomly divided into 3 groups according to the admission to hospital,20 cases in each group,the patients of 3 groups all received proximal gastrectomy,group A accepted esophagus jejunum end- to- side anastomosis type gastrointestinal revascularization,patients of group B accepted the residual stomach jejunum side-to-side anastomosis type gastrointestinal revascularization,patients of group C accepted jejunum-jejunum side-to-side anastomosis type gastrointestinal revascularization,three groups of patients accepted more than 1 year of follow- up visit,evaluated three groups of patients with esophageal reflux,hepatic and renal function,quality of life. Result: All patients were discharged from hospital upon rehabilitation after postoperative no serious complications had found during the follow-up period,such as anastomotic fistula,obstruction or narrowing. After the follow-up,three groups of hepatic and renal function indexes were found that had no statistical differences( P 0.05); During the follow-up period,there were respectively 1 case,7 cases and 4 cases had reflux esophagitis clinical symptoms in esophagus jejunum end-to-side anastomosis group,the residual stomach jejunum side-to-side anastomosis group,the jejunum-jejunum side-to-side anastomosis group( chi-square = 5.65,P = 0.023).According to the result of barium meal examination of upper gastrointestinal tract,3 groups respectively had1,5 and 9 patients found that barium reverse flow into the esophagus( chi-square = 6.46,P = 0.034). All items of life quality scale EORTCQLD-C30 scores of the three groups of patients significant increased after operation than preoperative,with statistically significant differences( P 0.05). In overall health status,patients of group A were obviously better than patients of the other two groups( P 0.05). Conclusion: Different methods of the digestive tract reconstruction can improve the life quality of patients with varying degrees,of which the esophagus jejunum end- to- side anastomosis type gastrointestinal revascularization have more apparent effect. It is recommended in the clinical.
Publication Year: 2015
Publication Date: 2015-01-01
Language: en
Type: article
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