| ObjectiveTo make an analysis and a comparison of the clinical effects of the distal gastrectomy between the delta-shaped and Billroth I and then evaluate the feasibility of the delta-shaped in the treatment of the distal gastrectomy.MethodAnalyze the clinical data of 34 cases, who underwent the delta-shaped and 83 cases,who underwent the Billroth I from March 2013 to July 2015 in the Department of Digestive Surgery from Shanxi Tumour Hospital affiliated to Shanxi Medical University; make a comparison of the two group’s duration of operation, the time of reconstruction of the digestive tract, the cadaverine quantity of bleeding, the length of incision, the amount of anodyne used after operation, the average days of recovery of gastrointestinal function, the length of stay after operation, the complication incidence rate during the perioperative period, such as infection of incisional wound, anastomotic leakage, and anastomotic stenosis, lymph gland, increment of dissected lymph node number, the incisal edges of specimen, the differences between the pre-operation and post-operation of the total protein and albumin, the average loss of weight in six months after operation; analyze the advantages and disadvantages of the two means of operation. Make a comparison of the related indicators of the patient with BMI>25kg/m2 before and after operation, and then explore the advantages and disadvantages of the two means of operation in obese patients.ResultMake an analysis of the various data of the 117 cases. In six months after leaving hospital, patients are required to have reexamination, one case of the delta-shaped did not have reexamination, and four cases of Billroth I have no reexamination indicators. Figure out the time of digestive tract reconstruction of the delta-shaped and Billroth I and the increment of dissected lymph node number, the incidences of complication, the incisal edges of specimen, the differences between the pre-operation and post-operation of the total protein and albumin, the loss of weight in six months after operation is of no statistical significance.(P>0.05) In the same medical team, the duration of operation for the first 15 cases of the delta-shaped is more than that of the Billroth I [(254.71±35.38)min vs(177.79±33.01)min P<0.05].after the learning curve,the duration of operation of the delta-shaped is less than that of the Billroth I [(142.07±14.64)min vs(177.79±33.01)min P<0.05]. In the delta-shaped, the postoperative exhaust time, the time of using liquid diets,the ambulation time, and the length of stay are less than that of the Billroth I [respectively(2.85±0.62)days vs(3.28±0.54)days,(7.38±±1.48)days vs(8.14±1.66) days,(4.00±1.56)days vs(6.79±1.37)days,(12.56±1.91)days vs(13.60±1.96)days, P<0.05];In the delta-shaped, the cadaverine quantity of bleeding during operation is less than that of the Billroth I [(87.06±36.72)ml vs(194.01±55.12)ml P < 0.05].In the delta-shaped, the length of incision is less than that of the Billroth I [(4.09±0.37)cm vs(6.11±1.03)cm P<0.05]. As for patients with BMI>25kg/m2, the delta-shaped is better than the Billroth I in terms of the cadaverine quantity of bleeding during operation, the amount of anodyne used after operation, the intestinal recovery time, the length of stay, and the incidence of complications.ConclusionIn the operation of the distal gastrectomy, the delta-shaped is safe and feasible.Compared with the Billroth I, it features small operative incision, little pain after operation,and good recovery. As for obese patients and patients with large anteroposterior diameter within the abdomen, they are suitable for the delta-shaped. |
PDF Full Text Request