关键词: 腹腔镜远端胃切除, 布朗吻合, Roux-en-Y式吻合, 胃癌, 胃肠功能

Abstract: Objective To analyze the effect of Brown anastomosis and Roux-en-Y anastomosis in laparoscopic distal gastrectomy on the curative effect and gastrointestinal function of patients with gastric cancer.Methods 120 patients with gastric cancer who underwent laparoscopic distal gastrectomy in our hospital from 08-2015 to 05-2017 were divided into group A and group B;The patients in group A were treated with Brown’s anastomosis,and the patients in group B were treated with Roux-en-Y anastomosis;The perioperative clinical related indicators of 2 groups were recorded;Enterococcus,Enterobacteriaceae,Bifidobacterium and Lactobacillus in intestinal flora before and 6 months after operation were analysed quantitatively;The serum CCK level was detected before operation and 6 months after operation;The patients were followed up for more than 5 years to record the 1 year postoperative complications and 5 year survival. Results There was no significant difference between group A and group B in operation time,intraoperative blood loss,postoperative exhaust time,gastric tube removal time,feeding time,drainage tube removal time and postoperative hospital stay (P>0.05); 6 months after operation,Enterococcus and Enterobacteria in group B were lower,while Lactobacillus and Bifidobacteria were higher than those in group A (P<0.05);6 months after operation,the level of CCK in group B was lower than that in group A (P<0.05);The incidence of gastric stump inflammation,gastric stump ulcer,gastric stump canceration,reflux esophagitis and cholecystolithiasis in group B was lower than that in group A (P<0.05);The 5 year survival rate of group B was higher than that of group A (P<0.05). Conclusion Laparoscopic distal gastrectomy Brown anastomosis and Roux-en-Y anastomosis have a higher clinical application effect on gastric cancer patients after intervention,and Roux-en-Y anastomosis has a lower impact on gastrointestinal function of patients,which improves the clinical efficacy of patients.

Key words: laparoscopic distal gastrectomy, brown fit, Roux-en-Y anastomosis, gastric cancer, gastrointestinal function