摘要
目的观察腹腔镜下二级前哨淋巴结技术同期行D2胃癌根治术对手术效果的影响。方法选取我院2013年6月—2014年6月收治的行D2胃癌根治术患者78例,随机分为试验组和对照组,每组39例,对照组行D2胃癌根治术,试验组应用二级前哨淋巴结(secondany sentinel lymph node,SSLN)技术同期行D2胃癌根治术,术后对2组患者进行18个月的随访;比较2组手术基本情况,主要包括手术时间、术中出血量与清除淋巴结数量,比较2组术后恢复情况,主要包括肛门排气时间、下床活动时间与住院时间,观察和比较2组术后并发症及复发情况,并随访了解其无瘤生存与存活情况。结果与对照组相比,试验组手术时间明显较长(P<0.01),但术中出血量明显较少、清除淋巴结数量显著较多(P<0.05);试验组肛门排气时间、下床活动时间、住院时间均明显较对照组短(P<0.01);试验组复发率及并发症发生率分别为10.26%、15.38%,明显低于对照组的28.21%、38.46%(P<0.05);试验组无瘤生存率为73.68%,显著高于对照组的51.38%(P<0.05),存活率为92.11%,略高于对照组的86.49%,比较差异无统计学意义(P>0.05)。结论 SSLN同期行D2胃癌根治术可显著提高手术效果,促进患者术后恢复,且可明显降低并发症发生率与复发率,提高无瘤生存率,对胃癌患者的临床治疗及远期生存有重要价值。
Objective To observe the effect of secondary sentinel lymph node with concurrent D2 radical resection of gastric cancer on the outcome of operations. Methods 78 cases of patients who had undergone D2 radical resection of gastric cancer at our hospital between June 2013 and June 2014 were selected and randomized into observation group and control group, with 39 cases in each. The control group underwent D2 radical resection of gastric cancer while the observation group underwent secondary sentinel lymph node （SSLN） with concurrent D2 radical resection of gastric cancer. After operation, the two groups were followed up for 18 months. The basic conditions of operation （operation time, intraoperative bleeding volume, the number of lymph nodes removed） and postoperative recovery （anal exhaust time, time of off-bed activities, length of hospital stay） were compared between the two groups. The incidence of postoperative complications and recurrence were observed and compared between the two groups. Follow-up was carried out to find out about the status of disease-free survival. Results The operation time of the observation group was visibly longer than that of the control group （P〈0.01）. However, the intraoperative bleeding volume was significantly less, and the number of lymph nodes removed was significantly larger （P〈0.05）. The anal exhaust time, time of off-bed activities and length of hospital stay of the observation group were visibly shorter than those of the control group （P〈0.01）. The recurrence rate and incidence of complications in the observation group （10.26%, 15.38%） were significantly lower than those in the control group （28.21%, 38.46%） （P〈0.05）. The disease-free survival rate in observation group （73.68%） was significantly higher than that in the control group （51.38%） （P〈0.05）. The survival rate （92.11%） was slightly higher than that in the control group （86.49% ） （P〉0.05）. Conclusion The application of SSLN with concurrent D2 radical resection of gastric cancer can significantly improve the operation results, promote recovery, significantly reduce the incidence of complications and recurrence rate, and boost disease-free survival. This approach is of important value in improving clinical curative effects and long-term survival.
出处
《空军医学杂志》
2016年第3期192-195,共4页
Medical Journal of Air Force
基金
四川省科技支撑计划(2014FZ0089)
