比洛斯 II 型吻合器联合棕色吻合器可减少胃癌患者的反流性胃炎

G. Christodoulidis, Marina-Nektaria Kouliou, Konstantinos-Eleftherios Koumarelas, Konstantinos Argyriou, Garyfallia-Apostolia Karali, Konstantinos Tepetes
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摘要

背景 执行远端胃切除术的外科医生有多种重建技术可供选择,比洛斯 II 就是其中之一。有证据表明,在比洛斯 II 期手术中进行的 Braun 吻合术在存活率方面优于典型的比洛斯 II 期吻合术,而且对术后发病率和死亡率没有影响。目的 比较比洛斯 II 与比洛斯 II 和博朗远端胃切除术后的术后情况。方法 将 2002 年至 2021 年期间接受远端胃切除术的患者根据所使用的手术技术分为两组(比洛斯 II:74 例患者;比洛斯 II 和布劳恩:28 例患者)。记录了鼻胃管(NGT)的每日输出量、术后拔除鼻胃管的日期以及患者开始经口进食的日期。同时记录术后并发症。然后对数据进行统计分析。结果 拔除 NGT 的平均天数和开始进食的平均天数存在差异。布劳恩组术后 NGT 的平均总输出量较低(399.17 mL vs 1102.78 mL),且有统计学意义(P < 0.0001)。博朗组术后 NGT 每日平均输出量也明显低于博朗组,具有统计学意义(P < 0.0001)。根据术后随访,比洛斯 II 组有 40 名患者出现胆汁反流和碱性胃炎,而接受比洛斯 II 和博朗吻合术的 9 名患者出现了同样的情况(P < 0.05)。结论 有证据表明,在胆汁反流、碱性胃炎和 NGT 输出量方面,Billroth II 和 Braun 与典型的 Billroth II 相比更具优势。
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Billroth II anastomosis combined with brown anastomosis reduce reflux gastritis in gastric cancer patients
BACKGROUND The surgeon performing a distal gastrectomy, has an arsenal of reconstruction techniques at his disposal, Billroth II among them. Braun anastomosis performed during a Billroth II procedure has shown evidence of superiority over typical Billroth II, in terms of survival, with no impact on postoperative morbidity and mortality. AIM To compare Billroth II vs Billroth II and Braun following distal gastrectomy, regarding their postoperative course. METHODS Patients who underwent distal gastrectomy during 2002-2021, were separated into two groups, depending on the surgical technique used (Billroth II: 74 patients and Billroth II and Braun: 28 patients). The daily output of the nasogastric tube (NGT), the postoperative day that NGT was removed and the day the patient started per os feeding were recorded. Postoperative complications were at the same time noted. Data were then statistically analyzed. RESULTS There was difference in the mean NGT removal day and the mean start feeding day. Mean total postoperative NGT output was lower in Braun group (399.17 mL vs 1102.78 mL) and it was statistically significant (P < 0.0001). Mean daily postoperative NGT output was also statistically significantly lower in Braun group. According to the postoperative follow up 40 patient experienced bile reflux and alkaline gastritis from the Billroth II group, while 9 patients who underwent Billroth II and Braun anastomosis were presented with the same conditions (P < 0.05). CONCLUSION There was evidence of superiority of Billroth II and Braun vs typical Billroth II in terms of bile reflux, alkaline gastritis and NGT output.
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