摘要
目的探讨开腹全胃切除术(OTG)联合D2淋巴结清扫术和腹腔镜全胃切除术(LATG)联合D2淋巴结清扫术在中上部进展期胃癌中的临床应用效果。方法回顾性分析2014年1月至2017年6月88例中上部进展期胃癌资料,均行全胃切除术联合D2淋巴结清扫,按手术方式差异分为腹腔镜组(简称LATG组,37例)和开腹组(简称OTG组,51例)。采用SPSS19.0进行统计分析,两组术中术后指标、VAS评分、肿瘤标准物等用(x±s)表示,独立t检验;术后无瘤生存率、术后总生存率和术后并发症发生率,行χ2检验,P<0.05为差异有统计学意义。结果研究结果显示LATG组手术时间、术中出血量、首次排气时间、首次进食时间、术中切口长度、术后住院时间、并发症总发生率(5.4%比21.6%)、术中相关指标、术后康复指标、术后1周、1个月的VAS评分、术后3个月的CA125、CA199、CEA水平等方面均较OTG组更优(P<0.05)。术中两组的淋巴结清扫数目差异无统计学意义(P>0.05);截止2018年12月,术后1年无瘤生存率和总生存率比较,两组差异无统计学意义(P>0.05)。结论LATG联合D2淋巴结清扫术是中上部进展期胃癌临床治疗的较为安全手术手术方法,具有出血量少,切口短小,术后康复快,术后疼痛感低,术后并发症较低的优势。
Objective To investigate the clinical effect of Open Total Gastrectomy(OTG)combined with D2 lymph node dissection and Laparoscopic total gastrectomy(LATG)combined with D2 lymph node dissection in advanced gastric cancer in the upper and middle part.Methods From January 2014 to June 2017,the data of 88 cases of advanced gastric cancer in the upper and middle parts were retrospectively analyzed.Total gastrectomy and D2 lymph node dissection were performed in all patients.According to the different operation,they were divided into Laparoscopic group(LATG group,37 cases)and open group(OTG group,51 cases).SPSS19.0 was used for statistical analysis.The intraoperative and postoperative indicators,VAS scores,tumor standard substances were expressed as(x±s),and compared with independent t test.After operation,the free survival rate,the total survival rate and the incidence of postoperative complications were compared withχ2 test,P<0.05 was P<0.05 was considered statistically significant.Result The results showed that the LATG group had better operative time,intraoperative bleeding volume,first exhaust time,first eating time,intraoperative incision length,post operative hospitalization time,total incidence of complications(5.4%vs.21.6%),intraoperative related indicators,post operative rehabilitation indicators,VAS scores of 1 week and,3 month of VAS,CA125,CA199,CEA levels after operation than OTG group(P<0.05).There was no significant difference in the number of lymph node dissections between the two groups(P>0.05).As of December 2018,there was no significant difference in 1 year tumor free survival rate and overall survival rate between the two groups(P>0.05).Conclusion LATG combined with D2 lymph node dissection is a safe surgical method for the treatment of advanced gastric cancer in the upper and middle part,It has the advantages of less bleeding,shorter incision,quicker recovery,lower pain and lowwe postoperative complications.
作者
李丽文
黄纪媛
Li Liwen;Huang Jiyuan(Shenzhen Longhua District People’s Hospital General Surgery,518109)
出处
《中华普外科手术学杂志（电子版）》
2020年第1期86-89,共4页
Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)
关键词
胃肿瘤
腹腔镜
剖腹术
胃切除术
淋巴结切除术
疗效比较研究
Stomach neoplasms
Laparoscopes
Laparotomy
Gastrectomy
Lymph node excision
Comparative effectiveness research
