摘要
目的:探讨保留脾脏的胃癌D2根治术中拖出式脾门淋巴结清扫与原位淋巴结清扫的疗效。方法:选取82例行腹腔镜D2全胃根治术的进展期近端胃癌患者,根据淋巴结清扫方式不同分为观察组和对照组,每组各41例。观察组患者术中行拖出式脾门淋巴结清扫;对照组患者术中行原位脾门淋巴结清扫。比较两组患者手术相关指标、术后恢复相关指标、术后并发症情况及术后1年总生存率。结果:观察组患者手术时间短于对照组;术中出血量低于对照组;清扫脾门淋巴结数量多于对照组,差异均有统计学意义(P<0.05);两组患者清扫脾门淋巴结总数、术后排气时间、流质饮食时间、拔除引流时间、住院时间、术后并发症发生及1年总生存率均无统计学差异(P>0.05)。结论:腹腔镜D2全胃根治术中,与原位脾门淋巴结清扫方式相比,拖出式脾门淋巴结清扫术手术时间更短,术中出血更少,且提高了脾门淋巴结清扫率。
Objective:To compare the curative effect of drag-out and orthotopic splenic hilar lymphadenectomy in gastric cancer D2 radical surgery with spleen-preserving.Methods:82 patients with advanced proximal gastric cancer undergoing laparoscopic D2 total radical surgery were enrolled and divided into observation group(n=41)and control group(n=41)according to different surgical methods.The observation group underwent drag-out splenic hilar lymphadenectomy,while control group underwent orthotopic splenic hilar lymphadenectomy.The surgical related indexes,postoperative recovery indexes,postoperative complications,and overall survival rate at 1 year after surgery were compared.Results:The operation time and intraoperative blood loss were shorter/lower in in observation group,dissection number of splenic hilar lymph nodes was more in observation group,the differences between the two groups were statistically significant(P<0.05).There was no significant difference between the two groups in the total number of lymph nodes,postoperative exhaust time,liquid diet time,drainage time,hospitalization time,postoperative complications and 1-year overall survival rate(P>0.05).Conclusion:Compared with iorthotopic splenic hilar lymphadenectomy,drag-out splenic hilar lymphadenectomy has shorter operation time and less intraoperative blood loss in laparoscopic D2 total gastric radical surgery,which is beneficial to improve dissection rate of splenic hilar lymph nodes.
作者
马卫平
李金利
郭昊苏
MA Wei-ping;LI Jin-li;GUO Hao-su(Department of Gastrointestinal Surgery,Yuncheng Central Hospital,Yuncheng 044000,Shanxi,China;Department of Gastroenterology,Yuncheng Central Hospital,Yuncheng 044000,Shanxi,China)
出处
《川北医学院学报》
CAS
2022年第10期1261-1263,共3页
Journal of North Sichuan Medical College
基金
山西省卫生健康委科研课题(2020158)。
关键词
胃癌
腹腔镜
根治术
脾门淋巴结
拖出
原位清扫
Gastric cancer
Laparoscope
Radical surgery
Splenic hilar lymph node
Drag out
Iorthotopic dissection
