中华普通外科杂志
中華普通外科雜誌
중화보통외과잡지
CHINESE JOURNAL OF GENERAL SURGERY
2008年
11期
821-824
,共4页
韦佳明%黄林平%贾振庚%Norio Shiraishi%Seigo Kitano
韋佳明%黃林平%賈振庚%Norio Shiraishi%Seigo Kitano
위가명%황림평%가진경%Norio Shiraishi%Seigo Kitano
胃肿瘤%胃切除术%腹腔镜检查%淋巴结切除术
胃腫瘤%胃切除術%腹腔鏡檢查%淋巴結切除術
위종류%위절제술%복강경검사%림파결절제술
Stomach neoplasms%Gastrectomy%Laparoscopy%Lymph node excision
目的 对比D1+β淋巴结廓清的腹腔镜辅助下远端胃切除术与D1+α淋巴结廓清的腹腔镜辅助下远端胃切除术的近期效果.方法 从2002年6月至2006年6月,以54例D1+α淋巴结廓清的腹腔镜辅助下远端胃切除术和42例D1+β淋巴结廓清的腹腔镜辅助下远端胃切除术作为研究对象,对比了两组间临床病理资料、手术所见、术后经过、并发症和实验室结果 .结果 D1+β淋巴结廓清比D1+α淋巴结廓清清扫了更多数量的第2站淋巴结[(5.9±3.7)个比(2.7±2.6)个,P<0.01),两组在清扫的淋巴结总数[(24.7±9.5)个比(22.2±11.3)个]和胃周淋巴结数[(18.9±7.6)个比(19.4±9.9)个]之间相比差异均无统计学意义.D1+β组与D1+α组在手术时间[(302±53)min比(289±68)min)、失血量[(160±195)ml比(141±312)ml]、并发症发生率(19%比13%)、首次下床步行、排气、进食和排便时间、镇痛剂给药频率、第7天进食量、体重下降量和术后住院时间[(19±12)d比(17±7)d]之间相比差异均无统计学意义.两组在血白细胞计数、C反应蛋白和血清白蛋白水平之间相比差异均无统计学意义.结论 腹腔镜辅助下远端胃切除术伴D1+β淋巴结廓清与腹腔镜辅助下远端胃切除术伴D1+α淋巴结廓清的短期效果类似.
目的 對比D1+β淋巴結廓清的腹腔鏡輔助下遠耑胃切除術與D1+α淋巴結廓清的腹腔鏡輔助下遠耑胃切除術的近期效果.方法 從2002年6月至2006年6月,以54例D1+α淋巴結廓清的腹腔鏡輔助下遠耑胃切除術和42例D1+β淋巴結廓清的腹腔鏡輔助下遠耑胃切除術作為研究對象,對比瞭兩組間臨床病理資料、手術所見、術後經過、併髮癥和實驗室結果 .結果 D1+β淋巴結廓清比D1+α淋巴結廓清清掃瞭更多數量的第2站淋巴結[(5.9±3.7)箇比(2.7±2.6)箇,P<0.01),兩組在清掃的淋巴結總數[(24.7±9.5)箇比(22.2±11.3)箇]和胃週淋巴結數[(18.9±7.6)箇比(19.4±9.9)箇]之間相比差異均無統計學意義.D1+β組與D1+α組在手術時間[(302±53)min比(289±68)min)、失血量[(160±195)ml比(141±312)ml]、併髮癥髮生率(19%比13%)、首次下床步行、排氣、進食和排便時間、鎮痛劑給藥頻率、第7天進食量、體重下降量和術後住院時間[(19±12)d比(17±7)d]之間相比差異均無統計學意義.兩組在血白細胞計數、C反應蛋白和血清白蛋白水平之間相比差異均無統計學意義.結論 腹腔鏡輔助下遠耑胃切除術伴D1+β淋巴結廓清與腹腔鏡輔助下遠耑胃切除術伴D1+α淋巴結廓清的短期效果類似.
목적 대비D1+β림파결곽청적복강경보조하원단위절제술여D1+α림파결곽청적복강경보조하원단위절제술적근기효과.방법 종2002년6월지2006년6월,이54례D1+α림파결곽청적복강경보조하원단위절제술화42례D1+β림파결곽청적복강경보조하원단위절제술작위연구대상,대비료량조간림상병리자료、수술소견、술후경과、병발증화실험실결과 .결과 D1+β림파결곽청비D1+α림파결곽청청소료경다수량적제2참림파결[(5.9±3.7)개비(2.7±2.6)개,P<0.01),량조재청소적림파결총수[(24.7±9.5)개비(22.2±11.3)개]화위주림파결수[(18.9±7.6)개비(19.4±9.9)개]지간상비차이균무통계학의의.D1+β조여D1+α조재수술시간[(302±53)min비(289±68)min)、실혈량[(160±195)ml비(141±312)ml]、병발증발생솔(19%비13%)、수차하상보행、배기、진식화배편시간、진통제급약빈솔、제7천진식량、체중하강량화술후주원시간[(19±12)d비(17±7)d]지간상비차이균무통계학의의.량조재혈백세포계수、C반응단백화혈청백단백수평지간상비차이균무통계학의의.결론 복강경보조하원단위절제술반D1+β림파결곽청여복강경보조하원단위절제술반D1+α림파결곽청적단기효과유사.
Objective Laparoscopy-assisted distal gsstrectomy (LADG) with D1 + β lymph node dissection has become the most popular treatment for early gastric cancer in Asian countries. However, no one has shown the same clinical advantages with this procedure as with LADG with D1 + α lymph node dissection. The aim of this study was to compare the outcome of LADG with D1 + β to that of LADG with D1 + α lymph node dissection. Methods During the period of June 2002 through June 2006, LADG with D1 + α lymph node dissection was performed in 54 patients, and LADG with D1 + β lymph node dissection was performed in 42 patients. Surgical findings, clinicopathologic data, postoperative course, complications, and blood analysis findings were compared between the two groups. Differences were analyzed with Mann-Whitney U test and chi-square test. Results Patients in the two groups were comparable with respect to age, sex, body mass index, and stage and pathologic characteristics of gastric cancer. A significantly greater number of N2 lymph nodes were harvested by D1 + β lymph node dissection than by D1 + α dissection (5.9vs. 2.7, P<0.01). However, no significanees in the total number of retrieved lymph nodes (24.7 vs. 22.2) or perigastric lymph nodes dissected (18.9 vs. 19.4) were identified between the D1 + β and D1 +α groups. There was also no significant difference between the D1 + α and D1 + β groups with respect to operation time, blood loss, complication rate, time to first walking, first flatus, first eating, and first defecation, frequency of analgesics, volume of oral intake on postoperative day 7, weight loss, and postoperative hospital stay. Blood analysis showed there were no significant differences in white blood cell count, levels of C-reactive protein, and serum albumin. Conclusion The short-term outcome of LADG with D1 + β lymph node dissection is comparable to that of LADG with D1 + α lymph node dissection.
