中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2012年
29期
6-8
,共3页
结肠系膜%胃切除术%胃肿瘤%胰腺
結腸繫膜%胃切除術%胃腫瘤%胰腺
결장계막%위절제술%위종류%이선
Mesocolon%Gastrectomy%Stomach neoplasms%Pancreas
目的 探讨胃癌根治术胰腺被膜及横结肠系膜前叶切除的短期疗效及癌转移相关因素.方法 将288例拟行胃癌根治术患者按机械抽样法随机分为术中切除胰腺被膜及横结肠系膜前叶组(观察组)145例和术中不切除胰腺被膜及横结肠系膜前叶组(对照组)143例.对手术切除标本进行病理组织学检查,判断胰腺被膜及横结肠系膜前叶是否存在癌转移；同时分析胰腺被膜及横结肠系膜前叶癌转移与各临床资料间的关系；并对两组手术时间、术中出血量、清扫淋巴结总数、术后并发症进行比较.结果 两组术中出血量、术后并发症发生率比较差异无统计学意义(P＞0.05)；观察组手术时间较对照组明显延长[(2.9±1.2)h比(2.3±0.9)h,P=0.036],清扫淋巴结总数较对照组明显增多[(20.5±7.5)枚比(13.5±9.3)枚,P=0.005].观察组胰腺被膜及/或横结肠系膜前叶存在癌转移12例(8.3％,12/145).胃癌胰腺被膜及/或横结肠系膜前叶癌转移与肿瘤位置、临床分期、浸润深度、淋巴结转移程度有关(P=0.039、0.022、0.041、0.009),而与患者性别、年龄、肿瘤部位、肿瘤直径、病理分级无关(P＞0.05).结论 胃癌根治术应合理切除胰腺被膜及横结肠系膜前叶.
目的 探討胃癌根治術胰腺被膜及橫結腸繫膜前葉切除的短期療效及癌轉移相關因素.方法 將288例擬行胃癌根治術患者按機械抽樣法隨機分為術中切除胰腺被膜及橫結腸繫膜前葉組(觀察組)145例和術中不切除胰腺被膜及橫結腸繫膜前葉組(對照組)143例.對手術切除標本進行病理組織學檢查,判斷胰腺被膜及橫結腸繫膜前葉是否存在癌轉移；同時分析胰腺被膜及橫結腸繫膜前葉癌轉移與各臨床資料間的關繫；併對兩組手術時間、術中齣血量、清掃淋巴結總數、術後併髮癥進行比較.結果 兩組術中齣血量、術後併髮癥髮生率比較差異無統計學意義(P＞0.05)；觀察組手術時間較對照組明顯延長[(2.9±1.2)h比(2.3±0.9)h,P=0.036],清掃淋巴結總數較對照組明顯增多[(20.5±7.5)枚比(13.5±9.3)枚,P=0.005].觀察組胰腺被膜及/或橫結腸繫膜前葉存在癌轉移12例(8.3％,12/145).胃癌胰腺被膜及/或橫結腸繫膜前葉癌轉移與腫瘤位置、臨床分期、浸潤深度、淋巴結轉移程度有關(P=0.039、0.022、0.041、0.009),而與患者性彆、年齡、腫瘤部位、腫瘤直徑、病理分級無關(P＞0.05).結論 胃癌根治術應閤理切除胰腺被膜及橫結腸繫膜前葉.
목적 탐토위암근치술이선피막급횡결장계막전협절제적단기료효급암전이상관인소.방법 장288례의행위암근치술환자안궤계추양법수궤분위술중절제이선피막급횡결장계막전협조(관찰조)145례화술중불절제이선피막급횡결장계막전협조(대조조)143례.대수술절제표본진행병리조직학검사,판단이선피막급횡결장계막전협시부존재암전이；동시분석이선피막급횡결장계막전협암전이여각림상자료간적관계；병대량조수술시간、술중출혈량、청소림파결총수、술후병발증진행비교.결과 량조술중출혈량、술후병발증발생솔비교차이무통계학의의(P＞0.05)；관찰조수술시간교대조조명현연장[(2.9±1.2)h비(2.3±0.9)h,P=0.036],청소림파결총수교대조조명현증다[(20.5±7.5)매비(13.5±9.3)매,P=0.005].관찰조이선피막급/혹횡결장계막전협존재암전이12례(8.3％,12/145).위암이선피막급/혹횡결장계막전협암전이여종류위치、림상분기、침윤심도、림파결전이정도유관(P=0.039、0.022、0.041、0.009),이여환자성별、년령、종류부위、종류직경、병리분급무관(P＞0.05).결론 위암근치술응합리절제이선피막급횡결장계막전협.
Objective To investigate the short-term effect of pancreatic capsule and anterior layer of transverse mesocolon in radical gastrectomy and analyze the cancerometastasis factor.Methods A total of 288 gastric cancer patients were randomly assigned into two groups:145 cases in observation group and 143 cases in control group.The patients only in observation group were given the pancreatic capsule and anterior layer of transverse mesocolon resecting during radical gastrectomy.The pancreatic capsule and anterior layer of transverse mesocolon were histologically analyzed for metastasis.The data including the operation time,blood loss during operation,number of dissected lymph nodes and postoperative complications were analyzed in both groups.Results There were no significant differences between two groups in the blood loss during operation and postoperative complications (P ＞ 0.05).The operation time in observation group was longer than that in control group [ (2.9 ± 1.2) h vs.(2.3 ± 0.9) h,P =0.036],the number of dissected lymph nodes in observation group was more than that in control group (20.5 ±7.5 vs.13.5 ±9.3,P =0.005).The metastasis to the pancreatic capsule and/or anterior layer of transverse mesocolon were diagnosed in 12 cases(8.3％,12/145) in observation group.The metastasis to the pancreatic capsule and/or anterior layer of transverse mesocolon were found to be associated with tumor location,clinical staging,invasion depth and degree of lymph node metastasis (P =0.039,0.022,0.041,0.009),but not with gender,age,tumor position,tumor diameter and pathological classification (P ＞ 0.05).Conclusions The resection is beneficial to the patients with advanced gastric cancer staging relatively late because of potential metastasis.The pancreatic capsule and anterior layer of transverse mesocolon should be legitimately resected in radical gastrectomy.
