Safety Analysis Of Retroperitoneal Mediastinal Siewert Ⅱ AEG Digestive Tract Reconstruction By Laparoscopy Assisted And Total Laparoscopy

Objective: To evaluate the safety and feasibility of the reconstruction of digestive tract in patients with total laparoscopic Gastro mediastinal Siewert Ⅱ AEG.Methods: From October 2016 to June 2019,32 patients in gastrointestinal surgery of Affiliated Hospital of Qinghai University were collected as the control group and 22 patients in the observation group.The general data,intraoperative indexes,postoperative recovery indexes,postoperative safety indexes and postoperative pathology indexes of the two groups were analyzed and compared retrospectively.Results: Compared with the control group,the operation time and digestive tract reconstruction time of the observation group were longer(control group: 153(132-170)min vs.observation group: 173(160-199.25)min,P = 0.001)and(control group: 23(20-25)min vs.observation group: 25.5(23-30)min,P = 0.001);in contrast,in terms of intraoperative bleeding,the observation group had less intraoperative bleeding(control group: 30(100-110)ml Observation group: 16.50(20-60)ml,P = 0.001),the difference was statistically significant.According to the postoperative pathological report,the number of lymph nodes in the abdominal cavity and mediastinum in the observation group was more than that in the control group(24.50(22-31)vs.31(28.75-35)in the observation group,P = 0.002)and(0(0-0)vs.0(0-1.25)in the observation group,P = 0.001).The difference was statistically significant.In terms of postoperative recovery index,the observation group was better than the control group,such as the first time of exhaust,the first time of defecation,the first time of fluid intake,the first time of half fluid intake,and the postoperative hospital stay.Conclusion: It is difficult to reconstruct the digestive tract of Siewert Ⅱ type AEG by laparoscopy.The operation time is relatively long.However,because of its small trauma and invasion,it can significantly reduce intraoperative bleeding,intraoperative and postoperative stress response,reduce postoperative pain,accelerate postoperative recovery,shorten postoperative hospital stay and other advantages,and it has the safety principle of radical treatment of tumor The above shows that it is safe and feasible.