摘要
目的探讨手助腹腔镜手术(HALS)在胃癌D_(2)根治术的临床疗效和安全性。方法选取2017年4月至2020年12月在马鞍山十七冶医院60例胃癌接受根治术的患者为研究对象,用抽签法随机分为HALS组30例和传统开腹(OS)组30例,比较两组患者术中、术后指标并随访生存情况,以2022年12月10日为末次随访时间。结果与OS组比较,HALS组手术时间长、术中失血量少、切口长度小、术后排气时间和术后全流质进食的时间以及术后下床时间早,手术后6 h、12 h、24 h、48 h的数字疼痛评定量表(NRS)评分低,差异有统计学意义(P<0.05)。两组腹部引流管拔除时间、术后住院日、清扫淋巴结数、无病生存期和总生存期差异无统计学意义(P>0.05)。HALS组术后并发症的总体发生率低于OS组,差异有统计学意义(16.67%vs 40.00%,χ^(2)=4.02,P<0.05)。结论HALS创伤小,术后并发症少,在胃癌的D_(2)根治术中是安全可行的。HALS结合了腹腔镜手术的微创特点和外科医生手的触觉,降低了手术操作难度,更方便进行复杂的腹腔手术,可以作为胃癌手术治疗方法之一。
Objective To investigate the clinical efficacy and safety of hand-assisted laparoscopic surgery(HALS)in D_(2)radical gastrectomy.Methods Sixty patients with gastric cancer who underwent radical surgery at Ma anshan Shiqiye Hospital from April 2017 to December 2020 were selected as the study subjects.They were randomly divided into a HALS group of 30 patients and a traditional open surgery(OS)group of 30 patients by a lottery method.The intra-and post-operative indicators of the two groups were compared,and the survival status was followed up on December 10,2022.Results In HALS group,the operation time was longer,the intraoperative blood loss and the incision length were smaller,time to exhaust,time to intaking total fluid diet and time to getting out of bed after operation were earlier,and the numerical pain rating(NRS)scores at 6-,12-,24-and 48-h after operation were lower,compared with those in OS group(P<0.05).There was no statistical difference in the removal time of abdominal drainage tubes,postoperative hospital stay,number of lymph nodes cleaned,disease-free survival and overall survival between two groups(P>0.05).The overall incidence of postoperative complications in HALS group was significantly lower than that in OS group(16.67%vs 40.00%,χ^(2)=4.02,P<0.05).Conclusion HALS has lesser trauma and fewer postoperative complications,with safe and feasible in D_(2)radical surgery for gastric cancer patients.HALS combines the minimally invasive characteristics of laparoscopic surgery with the touch of the surgeon s hand,which reduces the difficulty of operation and is more convenient for complicated abdominal surgery,and can become one of the surgical treatment methods for gastric cancer.
作者
黄一雄
高成钢
任伍保
冯万东
苏仕功
HUANG Yixiong;GAO Chenggang;REN Wubao;FENG Wandong;SU Shigong(Department of General Surgery,Ma anshan Shiqiye Hospital,Ma anshan,Anhui 243000,China)
出处
《中国临床研究》
CAS
2023年第9期1312-1316,1327,共6页
Chinese Journal of Clinical Research
基金
安徽省医疗卫生重点专科建设项目(皖卫科教发[2021]273号-85)
马鞍山市卫生计生委科技项目(马卫计办[2016]282号-8)。
