双类荷包加浆肌层间断缝合(徐氏三针法)包埋十二指肠对胃癌根治术患者术后并发症的影响

doi:10.3969/j.issn.1006-6233.2023.03.015

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摘要 目的: 分析双类荷包加浆肌层间断缝合(徐氏三针法)包埋十二指肠对胃癌根治术患者术后并发症的影响。方法: 回顾性选择安徽医科大学第一附属医院2018年1月至2022年3月收治的108例接受胃癌根治术患者,按照其十二指肠包埋方式,将接受浆肌层间断缝合者纳入对照组(n=50),将接受双类荷包加浆肌层间断缝合者纳入观察组(n=58)。对比两组患者手术情况、术后并发症发生情况,分析两种十二指肠包埋方法对手术进程及安全性的影响。结果: 观察组与对照组手术总时间、术中出血量比较,未见统计学差异(P>0.05),观察组十二指肠残端处理时间、住院费用较对照组更低(P<0.05)。观察组术后外科并发症发生率较对照组更低(P<0.05);观察组与对照组术后非外科并发症发生率比较,未见统计学差异(P>0.05)。观察组术后并发症Clavien-Dindo分级低于对照组(P<0.05)。结论: 与单纯浆肌层间断缝合包埋十二指肠相比,双类荷包缝合能够在不影响手术进程的前提下降低术后外科并发症发生率,从而显著减少患者住院费用。

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关键词 ：双类荷包缝合, 浆肌层间断缝合, 十二指肠, 胃癌根治术, 并发症

Abstract：Objective: To analyze the influence of double pouches and seromuscular layer discontinuous suture (Xu's three-needle method) embedding duodenum on postoperative complications of patients undergoing radical gastrectomy. Methods: A total of 108 patients who underwent radical gastrectomy in the First Affiliated Hospital of Anhui Medical University from January 2018 to March 2022 were selected retrospectively. According to the way of embedding duodenum, those who received intermittent suture of seromuscular layer were included in the control group (n=50), and those who received intermittent suture of two kinds of purse strings and seromuscular layer were included in the observation group (n=58). The operation conditions and postoperative complications of the two groups were compared, and the effects of two duodenal embedding methods on the operation process and safety were analyzed. Results: There was no statistical difference between the observation group and the control group in the total operation time and intraoperative blood loss (P>0.05). The treatment time and hospitalization expenses of duodenal stump in the observation group were lower than those in the control group (P<0.05). The incidence of postoperative complications in the observation group was lower than that in the control group (P<0.05). There was no statistical difference in the incidence of postoperative non-surgical complications between the observation group and the control group (P>0.05). Clavien-Dindo grade of postoperative complications in observation group was lower than that in control group (P<0.05). Conclusion: Compared with simple discontinuous suture of seromuscular layer to embed duodenum, double purse string suture can reduce the incidence of postoperative complications without affecting the surgical process, thus significantly reducing the hospitalization expenses of patients.

Key words： Double purse string suture Intermittent suture of muscular layer Duodenum Radical gastrectomy for gastric cancer Complication

基金资助:2020年度安徽高校自然科学研究项目,(编号:KJ2020A0171)

通讯作者: 徐阿曼

引用本文:

吴伙, 韩文秀, 韦之见, 郭爱军, 徐阿曼. 双类荷包加浆肌层间断缝合(徐氏三针法)包埋十二指肠对胃癌根治术患者术后并发症的影响[J]. 河北医学, 2023, 29(3): 427-431.
WU Huo, HAN Wenxiu, WEI Zhijian, et al. Effect of Double Pouch and Seromuscular Layer Discontinuous Suture (Xu's Three-Needle Method) Embedding Duodenum on Postoperative Complications of Patients Undergoing Radical Gastrectomy for Gastric Cancer. HeBei Med, 2023, 29(3): 427-431.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2023.03.015 或 http://www.hbyxzzs.cn/CN/Y2023/V29/I3/427

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