Objective To explore the effect of Roux-en-Y anastomosis without gastroesophageal stricture on quality of life in patients with distal gastric cancer after total laparoscopic surgery. Method 105 patients with distal gastric cancer were divided into experimental group (n = 53) and control group (n = 52) according to the patients' choice of operation in our hospital from February 2012 to July 2015. Roux-en-Y anastomosis of gastric jejunum was used in experimental group patients, while control group patients were treated with BillrothⅠ . Observed the total operation time, gastric tube retention time, exhaust time and intraoperative blood loss between the two groups; observed the dumping syndrome, gastric retention, residual gastritis and the incidence of reflux esophagitis after 1 year, and compared those data. Surveyed the satisfaution rate of patients using our own questonnaire and compared the data of the two groups. Result The total operation time, gastric tube retention time, the first exhaust time after operation and intraoperative blood loss in expenmental group were lower than that in control group (P < 0.05). After 1 year, there were no significant differences in dumping syndrome, gastric retention and residual gastritis between the two groups (P > 0.05). However, the incidence of reflux esophagitis in expenmental group was significantly lower than that that in control group (P < 0.05). The satisfaction rate of experimental group was higher than of control group (P < 0.05). Conclusion Roux-en-Y jejunum non-severed anastomosis for distal gastric cancer patients is a better choice, which can better reduce the occurrence of reflux esophagitis, so that patients are more satisfied with the treatment.%目的 探究胃空肠非离断式Roux-en-Y吻合对远端胃癌患者全腹腔镜术后生活质量的影响.方法 选取本院2012年2月至2015年7月收治的远端胃癌患者105例为研究对象,按照患者采取的术式不同,将其分为试验组(53例)和对照组(52例).试验组患者采用胃空肠非离断式Roux-en-Y吻合术,对照组患者采用BillrothⅠ式吻合术.观察并记录两组患者全程手术时间、胃管留置时间、排气时间及术中出血量,同时记录两组患者术后1年倾倒综合征、胃潴留、残余胃炎、反流性食管炎的发生情况.采用本院自制满意度调查表调查患者的满意率,并进行比较.结果 试验组患者的全程手术时间、胃管留置时间、术后首次排气时间均明显短于对照组(P<0.05),术中出血量明显少于对照组(P<0.05).术后1年,两组患者倾倒综合征、胃潴留、残余胃炎的发生率并无明显差异(P>0.05),但试验组患者反流性食管炎的发生率显著低于对照组(P<0.05).试验组患者的满意率(90.56%)明显高于对照组(75.00%)(P<0.05).结论 胃空肠非离断式Roux-en-Y吻合术对于远端胃癌患者是更优质的选择,该术式可以更好地减少反流性食管炎的发生,使患者对治疗更为满意.
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