摘要
目的:探讨内侧入路清扫胰上淋巴结在腹腔镜胃癌根治术中的应用价值。方法:选择2016年1月至2018年6月在我院行腹腔镜手术的104例远端胃癌患者作为研究对象,采用随机数字表法将患者分为对照组和观察组各52例。对照组采用常规入路清扫胰上淋巴结,观察组采用内侧入路清扫胰上淋巴结。观察2组患者手术时间、术中出血量、术后并发症(包括吻合口狭窄、胰瘘、腹腔脓肿,医院死亡率)、术后住院时间。结果:2组手术时间、输血率、中转手术率相比较差异均无统计学意义(P>0.05);2组术中失血量、吻合类型、体内吻合率、胰上淋巴结清扫数量等存在差异(P<0.05)。观察组并发症发生率低于对照组,但差异无统计学意义(P>0.05)。2组下地时间和院内死亡率相比较差异无统计学意义(P>0.05),观察组经口进食时间、住院时间均低于对照组,差异均有统计学意义(P<0.05)。结论:腹腔镜胃癌根治术中采用内侧入路清扫胰上淋巴结可提高淋巴结清扫数,促进术后恢复,值得进一步研究探讨。
Objective:To explore the value of medial approach for the lymphadenectomy of superior pancreatic lymph nodes in laparoscopic radical gastrectomy for gastric cancer.Methods:A total of 104 patients with distal gastric cancer who underwent laparoscopic surgery in our hospital from January 2016 to June 2018 were enrolled.The patients were divided into control group and observation group by 52 cases by random number table method.The control group was treated with conventional approach to clean the superior pancreatic lymph nodes,and the observation group used the medial approach to clean the superior pancreatic lymph nodes.The operation time,intraoperative blood loss,postoperative complications(including anastomotic stenosis,pancreatic fistula,abdominal abscess,hospital mortality)and postoperative hospital stay were observed in 2 groups.Results:There was no significant difference in the operation time,blood transfusion rate and transfer rate between the 2 groups(P>0.05),and there were differences in blood loss,type of anastomosis,rate of anastomosis in the body,and number of lymph nodes in the pancreas during the two groups(P<0.05).The incidence of complications in the observation group was lower than that in the control group,but the difference was not statistically significant(P>0.05).There was no significant difference between the two groups in Out-of-bed activity time and hospital mortality(P>0.05).The time of oral feeding and hospitalization in the observation group were lower than those in the control group,and the difference was statistically significant(P<0.05).Conclusion:In the laparoscopic radical gastrectomy,the use of the medial approach to clean the superior pancreatic lymph nodes can improve the number of lymph node dissection and promote postoperative recovery.It is worthy of further study.
作者
康海立
宁丽云
王志峰
沈静侠
魏彬
吴学队
王会生
Kang Haili;Ning Liyun;Wang Zhifeng;Shen Jingxia;Wei Bin;Wu Xuedui;Wang Huisheng(General Surgery Department,Qian'an People's Hospital,Hebei Tangshan 064400,China;Oncology Department,Qian'an People's Hospital,Hebei Tangshan 064400,China)
出处
《现代肿瘤医学》
CAS
2020年第1期79-82,共4页
Journal of Modern Oncology
基金
河北省2018年度医学科学研究重点课题(编号:20181407)
关键词
胃癌
腹腔镜
根治术
淋巴结清扫
gastric cancer
laparoscopy
radical correction
lymph node dissection
