A randomized controlled trial to establish a standard method for reconstruction after total gastrectomy

建立全胃切除术后重建标准方法的随机对照试验

• 批准号: 23591925
• 负责人: KODERA Yasuhiro
• 金额: $ 2.58万
• 依托单位: Nagoya University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 2011
• 资助国家: 日本
• 起止时间: 2011 至 2013
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-23591925/
• 关键词: 胃全摘術; 再建法; 胃癌; 空腸パウチ; 胃全摘術後再建法

Total gastrectomy substantially affects ongeneral status and quality of life through difficulty in food consumption. Recently, aboral pouch reconstruction (AP reconstruction) was reported in which reconstruction with a jejunal pouch can be performed easily using one extra set of linear staplers. In order to evaluate the efficacy and safety of this method, 100 patients who underwent R0 resection by total gastrectomy were randomized into either AP reconstruction or Roux-Y, and comparisons were made with various endpoints. No differences were found in operating time, amount of blood loss, morbidity and length of postoperative hospital stay, indicating that the AP reconstruction is safe. AP reconstruction was superior in terms of several items included in the EORTC QLQ-C30 questionnaire and lean body mass, but these differences did not reach statistical significance at one year after surgery. Further followup was deemed necessary, another survey at 3 years postoperatively.

全胃切除术通过进食困难严重影响患者的一般状况和生活质量。最近，报告了口外袋重建（AP重建），其中使用一套额外的直线型吻合器可以轻松地进行空肠袋重建。为了评价该方法的有效性和安全性，将100例接受全胃切除R0切除术的患者随机分为AP重建组或Roux-Y组，并对各种终点进行比较。两组在手术时间、术中出血量、术后并发症发生率及术后住院时间等方面均无差异，提示AP重建术是安全的。AP重建在EORTC QLQ-C30问卷中的几个项目和瘦体重方面具有上级优势，但这些差异在术后1年时未达到统计学显著性。认为有必要进行进一步随访，在术后3年进行另一次调查。