摘要
目的腹腔镜D2根治术(LD2RS)对局部进展期远端胃癌(LADGC)病人血清糖类抗原(CA)724、胃蛋白酶原(PG)及胃泌素-17(G-17)的影响。方法纳入2013年1月至2015年12月入住青海省交通医院的LADGC病人116例,依照随机数字表法分为腹腔镜组(n=58)与开腹组(n=58)。开腹组行开腹胃癌D2根治术(OD2RS)治疗,腹腔镜组行LD2RS治疗。观察两组手术及术后恢复指标,术前、术后7 d血清CA724、PG、G-17水平。术后并发症及术后3年生存情况等指标。结果腹腔镜组术中失血量(203.58±21.37)mL、切口长度(6.18±0.64)cm、术后排气时间(2.84±0.29)d、住院时间(10.95±1.14)d均短于开腹组(386.54±40.27)mL、(18.97±1.98)cm、(4.62±0.48)d、(16.84±1.73)d,P<0.05。腹腔镜组手术时间(279.54±29.96)min长于开腹组(213.64±22.97)min(P<0.05)。术后7 d,开腹组CA724(25.92±2.75)U/mL、PGⅠ(78.83±7.92)ng/mL、PGⅡ(18.95±1.90)ng/mL及G-17(62.95±6.33)ng/mL水平与腹腔镜组CA724(26.75±2.82)U/mL、(76.64±7.81)ng/mL、(19.06±1.96)ng/mL、(64.84±6.59)ng/mL水平差异无统计学意义(P>0.05)。腹腔镜组术后并发症发生率(6.90%)低于开腹组(22.41%),P<0.05。腹腔镜组术后3年无瘤生存率31.03%(18/58)、总体生存率39.65%(23/58)与开腹组术后3年无瘤生存率34.48%(20/58)、总体生存率43.10%(25/58)差异无统计学意义(P>0.05)。结论LD2RS治疗LADGC创伤小,术后恢复快,可有效清除CA724、PGⅠ、PGⅡ及G-17,术后并发症发生率低,可达到与OD2RS相同的疗效。
Objective To study the effect of laparoscopic D2 radical surgery on serum CA724,pepsinogen(PG)and gastrin-17(G-17)in patients with locally advanced distal gastric cancer(LADGC).Methods One hundred and sixteen patients with LADGC admitted to Qinghai Provincial Traffic Hospital from January 2013 to December 2015 were selected and assigned into laparoscopic group(n=58)and open group(n=58)according to the random number table method.The open group received OD2RS treatment,while the laparoscopic group received LD2RS treatment.The indexes of operation and postoperative recovery including serum CA724,PG,G-17 levels before and 7 days after operation were observed,and postoperative complications and 3-year survival after operation were observed.Results The blood loss(203.58±21.37)mL,incision length(6.18±0.64)cm,postoperative exhaust time(2.84±0.29)d and hospitalization time(10.95±1.14)d in laparoscopic group were shorter than the blood loss(386.54±40.27)mL,incision length(18.97±1.98),postoperative exhaust time(4.62±0.48)d and hospitalization time(16.84±1.73)d in open group(P<0.05).The operation time(279.54±29.96)min in laparoscopic group was longer than the operation time(213.64±22.97)min in open group(P<0.05).7 days after surgery,the levels of CA724(25.92±2.75)U/mL,PGⅠ(78.83±7.92)ng/mL,PGⅡ(18.95±1.90)ng/mL and G-17(62.95±6.33)ng/mL in the laparoscopy group were significantly higher than the levels of CA724(26.75±2.82)U/mL,PGⅠ(76.64±7.81)ng/mL,PGⅡ(19.06±1.96)ng/mL and G-17(64.84±6.59)ng/mL in the operation time,there was no significant difference(P>0.05).The incidence of postoperative complications(6.90%)in laparoscopic group was lower than that in open group(22.41%)(P<0.05).There was no significant difference in the 3-year disease-free survival rate(31.03%)and overall survival rate(39.65%)between the laparoscopic group and the open group(34.48%,20/58)and the overall survival rate(43.10%,25/58)(P>0.05).Conclusion LD2RS can effectively remove CA724,PGⅠ,PGⅡand G-17 after treatment of LADGC with little trauma and rapid recovery.The incidence of complications after operation is low,and it can achieve the same curative effect as OD2RS.
作者
王新栋
李德元
曹贵章
WANG Xindong;LI Deyuan;CAO Guizhang(Department of General Surgery,Qinghai Communications Hospital,Xining,Qinghai 810001,China)
出处
《安徽医药》
CAS
2021年第10期2048-2051,共4页
Anhui Medical and Pharmaceutical Journal
