| Objective: Retrospective observational analysis of the change of blood sugar in laparoscopic assisted radical total gastric resection Roux en- Y anastomosis on postoperative gastric cancer patients with diabetes mellitus.To evaluate the effection of surgical treatment of gastric cancer combined with type 2 diabetes.Methods: This article selects the Second Affiliated Hospital of Dalian Medical Unicersity in January 2010 – June 2014,45 patients of gastric cancer combined with type 2 diabetes patients laparoscopic assisted radical total gastric resection Roux en- Y anastomosis clinical data. All patients were taken under gastroscope pathological examination diagnosis of gastric cancer, preoperative has a history of type 2 diabetes, has been the traditional medicine hypoglycemic therapy before surgery. Male 35 cases, 10 cases of women, ratio of 3.5:1, Patient age range of 42-80,Preoperative diabetes treatment:18 patients diet exercise therapy,23 patients of oral hypoglycemic drugs,and 4 patients of oral hypoglycemic drugs and subcutaneous insulin injections combination therapy. According to different body mass index of BMI, the divided into BMI ≤ 25 for group A, BMI > 25 for group B.Some rich experience of chief physicians had completed the operation.The comparative analysis of two groups of patients with preoperative and postoperative 7 days, 3 months and 6 months after operation the changes of fasting blood glucose, and watch the six months after A, B two groups between fasting blood glucose value, compared two groups of postoperative efficacy for the treatment of type 2 diabetes.All the data using SSPS17.0 statistical analysis software, inspection level to choose P < 0.05 difference was statistically significant.Results: 45 patiens all the smooth implementation of laparoscopic assisted radical total gastric resection Roux en- Y anastomosis, the operation completed successfully, no transfer laparotomy cases.42 cases of patients were in normal time(7-9 days) after discharge, there are 3 patients appeared different degree of postoperative complications, including 1 case of patients with anastomotic fistula, 1 case of helicobacter inflammatory obstruction, and 1 case of lower extremity deep vein thrombosis, both by positive conservative treatment after hospital discharge.Two groups of patients with postoperative fasting blood glucose significantly lower than before the surgery, a statistically significant difference(P < 0.05), A、B two groups of postoperative diabetes period were 73%, 64%, the cure rate of 68%, 59%. Six months after A, B two groups between fasting blood glucose and compare the effectiveness of the surgical treatment of type 2 diabetes, no statistical significance(P > 0.05).Conclusion: laparoscopic assisted radical total gastric resection Roux en- Y anastomosis in patients with gastric cancer combined with type 2 diabetes has obvious therapeutic effect, the operation is not only a complete resection of the cancer disease stove, effectively improve the patients postoperative blood glucose levels at the same time. Effect of the surgery has nothing to do with preoperative body weight, normal weight and overweight patients the surgery is effective, its mechanism could “disappear with the stomach”,the digestive tract reconstruction in the digestive tract gastrointestinal hormones secretion level change, adipose cytokines and inflammatory cytokine levels change, and have the advantages of laparoscopic related to trauma patients with small, beautiful, postoperative healing of incision, increase of speed, etc., so the laparoscopic assisted radical total gastric resection Roux en- Y anastomosis gastric cancer combined with type 2 diabetes is effective way of operation. |
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