腹腔镜胃远端切除术后,体内三角形胃十二指肠造口术和胃空肠造口术的长期功能和患者报告结果。

IF 4.3 3区 材料科学 Q1 ENGINEERING, ELECTRICAL & ELECTRONIC ACS Applied Electronic Materials Pub Date : 2023-10-01 DOI:10.5230/jgc.2023.23.e35
Sin Hye Park, Hong Man Yoon, Keun Won Ryu, Young-Woo Kim, Mira Han, Bang Wool Eom
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引用次数: 0

摘要

目的:本研究旨在比较癌症腹腔镜远端胃切除术后经腔三角形胃十二指肠狭窄与胃肠造口术的长期功能和患者报告的结果。材料和方法:我们回顾性分析了2015年1月至2020年9月期间616例癌症I期腹腔镜远端胃切除术患者的临床病理数据。其中,232名接受过三角形吻合的患者和另外232名接受Billroth II吻合的患者使用倾向评分进行匹配。令人困惑的变量包括年龄、性别、体重指数、身体状况分类、肿瘤位置和T分类。比较两组患者的术后并发症、营养状况、内镜检查结果和生活质量(QoL)。结果:两组患者术后并发症及营养参数无明显差异。年度内镜检查结果显示,德尔塔组残留食物较多,胆汁反流较少(P结论:delta组和Billroth II组的长期营养结果和生活质量具有可比性。然而,在delta组中观察到更多的残余食物和更差的失眠、反流症状和口干方面的短期生活质量。在内镜评估和短期症状管理之前更长的禁食时间将有助于delta组。
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Long-term Functional and Patient-reported Outcomes Between Intra-corporeal Delta-shaped Gastroduodenostomy and Gastrojejunostomy After Laparoscopic Distal Gastrectomy.

Purpose: This study aimed to compare the long-term functional and patient-reported outcomes between intra-corporeal delta-shaped gastroduodenostomy and gastrojejunostomy after laparoscopic distal gastrectomy for gastric cancer.

Materials and methods: We retrospectively reviewed clinicopathological data from 616 patients who had undergone laparoscopic distal gastrectomy for stage I gastric cancer between January 2015 and September 2020. Among them, 232 patients who had undergone delta-shaped anastomosis and another 232 who had undergone Billroth II anastomosis were matched using propensity scores. Confounding variables included age, sex, body mass index, physical status classification, tumor location, and T classification. Postoperative complications, nutritional outcomes, endoscopic findings, and quality of life (QoL) were compared between the 2 groups.

Results: No significant differences in postoperative complications or nutritional parameters between the two groups were observed. Annual endoscopic findings revealed more residual food and less bile reflux in the delta group (P<0.001) than in the Billroth II group. Changes of QoL were significantly different regarding emotional function, insomnia, diarrhea, reflux symptoms, and dry mouth (P=0.007, P=0.002, P=0.013, P=0.001, and P=0.03, respectively). Among them, the delta group had worse insomnia, reflux symptoms, and dry mouth within three months postoperatively.

Conclusions: Long-term nutritional outcomes and QoL were comparable between the delta and Billroth II groups. However, more residual food and worse short-term QoL regarding insomnia, reflux symptoms, and dry mouth were observed in the delta group. Longer fasting time before endoscopic evaluation and short-term symptom management would have been helpful for the delta group.

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