中华普通外科杂志
中華普通外科雜誌
중화보통외과잡지
CHINESE JOURNAL OF GENERAL SURGERY
2012年
10期
794-797
,共4页
蒋国庆%陈平%柏斗胜%钱建军%姚捷%王小东%鱼海峰%王道荣
蔣國慶%陳平%柏鬥勝%錢建軍%姚捷%王小東%魚海峰%王道榮
장국경%진평%백두성%전건군%요첩%왕소동%어해봉%왕도영
胃肿瘤%腹腔镜%胃切除术%手术后并发症
胃腫瘤%腹腔鏡%胃切除術%手術後併髮癥
위종류%복강경%위절제술%수술후병발증
Stomach neoplasms%Laparoscopes%Gastrectomy%Postoperative complications
目的 探讨腹腔镜辅助胃癌D2根治术并发症的防治及其临床价值.方法 同顾性分析我院2010年1月至2011年12月分别接受腹腔镜全胃切除胃癌D2根治术(腹腔镜组165例)及开腹全胃切除胃癌D2根治术(开腹组193例)共358例胃癌患者的临床资料.将手术情况、术后恢复情况和并发症进行比较. 结果 腹腔镜组中位手术时间为225( 195～340) min,开腹组为230(195～300) min,两组之间相比差异无统计学意义(P＞0.05)；腹腔镜组淋巴结清扫数目为(26±4)枚,开腹组为(27±4)枚,两组之间相比差异无统计学意义(P＞0.05)；腹腔镜组中位术中失血量为160(80～600) ml,显著低于开腹组的270(150～600)ml,两组相比差异有统计学意义(P＜0.01)；腹腔镜组术后平均住院(11.4±2.6)d,显著低于开腹组的(13.7±2.4)d,两组相比差异有统计学意义(P＜0.01).腹腔镜组的术后并发症共18例,开腹组共30例,两组之间相比差异无统计学意义(P＞0.05).两组均无围手术期死亡病例.结论 腹腔镜辅助胃癌D2根治术是安全可行的,并能有效地防治手术的并发症,更能体现创伤小、并发症少、恢复快的特点.
目的 探討腹腔鏡輔助胃癌D2根治術併髮癥的防治及其臨床價值.方法 同顧性分析我院2010年1月至2011年12月分彆接受腹腔鏡全胃切除胃癌D2根治術(腹腔鏡組165例)及開腹全胃切除胃癌D2根治術(開腹組193例)共358例胃癌患者的臨床資料.將手術情況、術後恢複情況和併髮癥進行比較. 結果 腹腔鏡組中位手術時間為225( 195～340) min,開腹組為230(195～300) min,兩組之間相比差異無統計學意義(P＞0.05)；腹腔鏡組淋巴結清掃數目為(26±4)枚,開腹組為(27±4)枚,兩組之間相比差異無統計學意義(P＞0.05)；腹腔鏡組中位術中失血量為160(80～600) ml,顯著低于開腹組的270(150～600)ml,兩組相比差異有統計學意義(P＜0.01)；腹腔鏡組術後平均住院(11.4±2.6)d,顯著低于開腹組的(13.7±2.4)d,兩組相比差異有統計學意義(P＜0.01).腹腔鏡組的術後併髮癥共18例,開腹組共30例,兩組之間相比差異無統計學意義(P＞0.05).兩組均無圍手術期死亡病例.結論 腹腔鏡輔助胃癌D2根治術是安全可行的,併能有效地防治手術的併髮癥,更能體現創傷小、併髮癥少、恢複快的特點.
목적 탐토복강경보조위암D2근치술병발증적방치급기림상개치.방법 동고성분석아원2010년1월지2011년12월분별접수복강경전위절제위암D2근치술(복강경조165례)급개복전위절제위암D2근치술(개복조193례)공358례위암환자적림상자료.장수술정황、술후회복정황화병발증진행비교. 결과 복강경조중위수술시간위225( 195～340) min,개복조위230(195～300) min,량조지간상비차이무통계학의의(P＞0.05)；복강경조림파결청소수목위(26±4)매,개복조위(27±4)매,량조지간상비차이무통계학의의(P＞0.05)；복강경조중위술중실혈량위160(80～600) ml,현저저우개복조적270(150～600)ml,량조상비차이유통계학의의(P＜0.01)；복강경조술후평균주원(11.4±2.6)d,현저저우개복조적(13.7±2.4)d,량조상비차이유통계학의의(P＜0.01).복강경조적술후병발증공18례,개복조공30례,량조지간상비차이무통계학의의(P＞0.05).량조균무위수술기사망병례.결론 복강경보조위암D2근치술시안전가행적,병능유효지방치수술적병발증,경능체현창상소、병발증소、회복쾌적특점.
Objective To evaluate postoperative complications of laparoscopy-assisted D2 radical total gastrectomy for gastric cancer as compared with open procedures. Methods In this study,358 patients of gastric cancer undergoing laparoscopy-assisted D2 total gastrectomy or open D2 total gastrectomy between January 2011 and December 2012 were retrospectively reviewed and analyzed.Patients were non-randomly divided into laparoscopic group ( LAP,n =165 ) and open surgery group ( OPEN,n =193 ).Operative time,intraoperative blood loss,postoperative hospital stay and complications were compared between the two groups. Results Operative time [ 225 ( 195 - 340 ) min vs.230 ( 195 - 300 ) min,P ＞0.05 ] and number of lymph nodes dissected [ (26 ± 4) vs.(27 ± 4 ),P ＞ 0.05] between the LAP group and the OPEN group were not significantly different.Compared with OPEN group,blood loss in the LAP group was less [ 160 ( 80 - 600 ) ml vs.270 ( 150 - 600) ml,P ＜ 0.01 ] and postoperative hospital stay was shorter [ ( 11.4 ± 2.6) d vs.( 13.7 ± 2.4) d,P ＜ 0.01 ].Postoperative complications developed in 18 patients in the LAP group and in 30 patients in the OPEN group,the difference was not statistically significant between the two groups. Conclusions In the hands of experienced surgeons laparoscopy-assisted D2 radical total gastrectomy for gastric cancer is safe,effective and miniinvasive.
