CAJ | 학술논문

目的探讨肥胖对腹腔镜辅助胃癌根治术近期疗效的影响.方法回顾性分析2007年5月至2010年6月间在福建医科大学附属协和医院接受腹腔镜辅助胃癌根治术的531例患者的临床资料,其中BMI大于或等于25 kg/m2者83例(肥胖组),小于25 kg/m2者448例(非肥胖组).比较两组患者术中、术后及近期生存情况.结果肥胖组与非肥胖组患者中转开腹率分别为2.4％(2/83)和1.8％(8/448),差异无统计学意义(P＞0.05).除手术时间肥胖组高于非肥胖组外[(224.7±57.3) min比(210.0±57.9) min,P＜0.05],两组术中出血量、术中输血率、术后第1天白细胞和中性粒细胞增加数、体温恢复时间、肛门排气时间及术后住院时间的差异均无统计学意义(均P＞0.05).肥胖组平均淋巴结清扫数目为(24.8±8.4)枚/例,明显少于非肥胖组的(29.9±10.2)枚/例(P＜0.05).肥胖组与非肥胖组术后并发症发生率分别为16.8％(14/83)和10.2％(46/448),围手术期死亡率分别为1.2％(1/83)和0.4％(2/448),3年生存率分别为68.8％和74.0％,差异均无统计学意义(均P＞0.05).结论肥胖虽然会延长腹腔镜胃癌根治术的手术时间,但并不会影响手术安全性和近期疗效.
목적 탐토비반대복강경보조위암근치술근기료효적영향.방법 회고성분석2007년5월지2010년6월간재복건의과대학부속협화의원접수복강경보조위암근치술적531례환자적림상자료,기중BMI대우혹등우25 kg/m2자83례(비반조),소우25 kg/m2자448례(비비반조).비교량조환자술중、술후급근기생존정황.결과 비반조여비비반조환자중전개복솔분별위2.4％(2/83)화1.8％(8/448),차이무통계학의의(P＞0.05).제수술시간비반조고우비비반조외[(224.7±57.3) min비(210.0±57.9) min,P＜0.05],량조술중출혈량、술중수혈솔、술후제1천백세포화중성립세포증가수、체온회복시간、항문배기시간급술후주원시간적차이균무통계학의의(균P＞0.05).비반조평균림파결청소수목위(24.8±8.4)매/례,명현소우비비반조적(29.9±10.2)매/례(P＜0.05).비반조여비비반조술후병발증발생솔분별위16.8％(14/83)화10.2％(46/448),위수술기사망솔분별위1.2％(1/83)화0.4％(2/448),3년생존솔분별위68.8％화74.0％,차이균무통계학의의(균P＞0.05).결론 비반수연회연장복강경위암근치술적수술시간,단병불회영향수술안전성화근기료효.
Objective To study the impact of obesity on the short-term outcomes after laparoscopic-assisted radical gastrectomy.Methods A total of 531 gastric cancer patients underwent radical resection at the Fujian Medical University Union Hospital between May 2007 and June 2010.There were 83 patients with BMI≥25 kg/m2(obese group) and 448 patients with BMI＜25 kg/m2 (non-obese group).Intraoperative and postoperative parameters,and short-term survival rates between the two groups were compared.Results There was no significant difference between obese and nonobese patients in terms of conversion rate (2.4％ vs.1.8％,P＞0.05).The operative time in obese group was (224.7±57.3) min,which was significantly longer than that in non-obese group [(210.0±57.9) min,P＜0.05].However,no statistically significant differences were observed between obese and non-obese groups in terms of blood loss,blood transfusion rate,elveated leukocyte and granulocyte count on the first postoperative day,time to temperature recovery,fast flatus,and postoperative hospital stays (P＞0.05).The mean number of retrieved lymph nodes in obese group was (24.8±8.4),and was significantly less than that of non-obese group [(29.9±10.2),P＜0.05].There were no significant differences between obese and non-obese groups in postoperative complication rate (16.8％vs.10.2％,P＞0.05),postoperative mortality (1.2％ vs.0.4％,P＞0.05),and 3-year overall survival (68.8％ vs.74.0％,P＞0.05).Conclusions Obesity is associated with prolonged operative time for laparoscopic radical gastrectomy.However,the short-term outcomes after the laparoscopic radical gastrectomy is not infiuenced by obesity.