摘要
目的探讨不同微创方式治疗胃癌的效果及其并发症Clavien-Dindo分级和影响因素分析。方法选取2015年5月至2017年5月晋城市人民医院普通外科收治的80例行腹腔镜远端胃癌根治术患者，根据手术方式不同分为全腹腔镜组与腹腔镜辅助组，每组40例。全腹腔镜组采用全腹腔镜胃癌根治术，腹腔镜辅助组采用腹腔镜辅助胃癌根治术，比较两组患者围术期相关指标、术后并发症发生情况等。结果全腹腔镜组手术时间[（265．5±24．8）min]显著长于腹腔镜辅助组[（227．2±22．0）min]，差异有统计学意义（P〈0．05）；全腹腔镜组术中出血量[（245．4±55．4）m1]、切口长度[（3．5±0．6）cm]、术后排气时间[（2．5±0．6）d]、术后住院时间[（8．3±2．6）d]及术后疼痛评分[（1．6±0．6）分]均低于腹腔镜辅助组[（310．8±57．1）rain、（6．2±1．4）ml、（3．3±1．2）d、（11．5±2．2）d、（4．5±1．1）分]，差异有统计学意义（P〈0．05）；两组患者的淋巴结清扫数目比较，差异无统计学意义（P〉0．05）。两组患者术后并发症比较，差异无统计学意义（P〉0．05）。两组患者的年龄、体质量指数、肿瘤大小、手术时间及术中出血量是影响微创胃癌根治术后发生并发症的独立影响因素（P〈0．05）。结论全腹腔镜远端胃癌根治术治疗胃癌的效果显著，应及时关注与并发症相关的影响因素，做好围术期处理，从而提高其安全性。
Objective To investigate the effect of different minimally invasive methods on gastric cancer and the analysis of complications influencing factors. Methods 80 cases of patients with gastric cancer were admitted from May 2015 to May 2017. According to different surgical methods, patients were randomly divided into the total laparoscopic distal gastrectomy（TLDG） group and the laparoscopic assisted distal gastrectomy（LADG） group,with 40 cases in each group. The perioperative indicators and postopera-tive complications were compared between the two groups. Results The operative time of the TLDG group was significantly longer than that of the LADG group [ （265.5 ± 24. 8 ） rain versus （227.2 ± 22.0） rain, and the difference was statistically significant （ P 〈 0. 05）. Bleeding amount of TLDG group was （ 245.4 ± 55.4 ） ml, incision length was（3.5 ± 0. 6） cm, postoperative exhaust time was（2. 5 ± 0. 6） d, postoperative hospitalization time was （8. 3 ± 2. 6） d and postoperative pain score was （ 1.6 ± 0. 6）, which were lower than those of LADG group [ （310. 8 ＋ 57.1 ） min, （6. 2 ± 1.4） ml, （3.3 ＋ 1.2） d, （ 11.5 ± 2.2） d and （4. 5 ± 1.1 ） ] , and the differences were statistically significant （ P 〈 0. 05 ）. There was no statistically significant difference between the two groups in the number of lymph node dissection（ P 〉 0. 05 ）. Postoperative complica- tions of the two groups were compared without statistically significant difference （ P 〉 0. 05 ）. Age, body mass index, tumor size, duration of surgery and intraoperative blood loss were independent factors influencing com-plications after minimally invasive radical gastrectomy （ P 〈 0. 05 ）. Conclusion The TLDG approach has a more significant advantage on patients with gastric cancer. It is necessary to pay attention to the factors related to complications in a timely manner and do a good perioperative treatment to improve safety.
作者
周常青
王路晋
张向忠
Zhou Changqing;Wang Lufin;Zhang Xiangzhong(Department of General Surgery,Jincheng People＇s Hospital,Jincheng 048000,China)
出处
《中国临床实用医学》
2018年第4期18-21,共4页
China Clinical Practical Medicine
