CAJ | 학술논문

目的：探讨肥胖对腹腔镜辅助胃癌根治术手术安全性的影响。方法回顾性分析北京肿瘤医院胃肠肿瘤微创外科在2009年5月至2012年12月间行腹腔镜辅助胃癌根治术的214例患者的临床资料，其中体质量指数大于或等于25 kg/m2者66例（肥胖组），低于25 kg/m2者148例（非肥胖组），比较两组患者的手术及术后恢复情况。结果肥胖组手术时间（271．5±51．2） min，明显长于非肥胖组的（252．1±53．6） min（P＜0．05）；清扫淋巴结数目（26．2±10．3）枚，少于非肥胖组的（30．3±12．4）枚（P＜0．05）。但两组术中失血量、术中输血率、中转开腹率、术后排气时间和住院时间等差异均无统计学意义（均P＞0．05）。肥胖组术后并发症发生率为25．8％（17/66）和20．9％（31/148），差异无统计学意义（P＞0．05），但肥胖组手术相关轻微并发症（Clavien-Dindo分级Ⅰ、Ⅱ级）发生率（16．7％，11/66）高于非肥胖组（6．8％，10/148），差异有统计学意义（P＜0.05）。两组术后30 d内死亡率分别为1．5％（1/66）和0．7％（1/148），差异无统计学意义（P＞0．05）。结论肥胖患者会延长腹腔镜辅助胃癌根治术的手术时间，增加轻微并发症的风险，但并不影响手术的安全性。
목적：탐토비반대복강경보조위암근치술수술안전성적영향。방법회고성분석북경종류의원위장종류미창외과재2009년5월지2012년12월간행복강경보조위암근치술적214례환자적림상자료，기중체질량지수대우혹등우25 kg/m2자66례（비반조），저우25 kg/m2자148례（비비반조），비교량조환자적수술급술후회복정황。결과비반조수술시간（271．5±51．2） min，명현장우비비반조적（252．1±53．6） min（P＜0．05）；청소림파결수목（26．2±10．3）매，소우비비반조적（30．3±12．4）매（P＜0．05）。단량조술중실혈량、술중수혈솔、중전개복솔、술후배기시간화주원시간등차이균무통계학의의（균P＞0．05）。비반조술후병발증발생솔위25．8％（17/66）화20．9％（31/148），차이무통계학의의（P＞0．05），단비반조수술상관경미병발증（Clavien-Dindo분급Ⅰ、Ⅱ급）발생솔（16．7％，11/66）고우비비반조（6．8％，10/148），차이유통계학의의（P＜0.05）。량조술후30 d내사망솔분별위1．5％（1/66）화0．7％（1/148），차이무통계학의의（P＞0．05）。결론비반환자회연장복강경보조위암근치술적수술시간，증가경미병발증적풍험，단병불영향수술적안전성。
Objective To investigate the influence of obesity on short-term outcomes after laparoscopy-assisted radical gastrectomy. Methods Clinical data of 214 patients with gastric cancer, who underwent laparoscopy-assisted radical gastrectomy between May 2009 and December 2012 were analyzed retrospectively. Patients were divided into two groups, consisting of obese and non-obese patients. In the obese group, the BMI was ≥25.0 kg/m2(n=66), and in the non-obese group was <25.0 kg/m2 (n=148). Operative procedure and postoperative recovery were compared between the two groups. Results The operative time was longer in obese group than that in non-obese group [(271.5±51.2) min vs. (252.1±53.6) min, P<0.05]. The number of retrieved lymph nodes in obese group was less than that in non-obese group (26.2 ±10.3 vs. 30.3 ±12.4, P<0.05). No significant differences were observed in terms of blood loss, blood transfusion rate, conversion to laparotomy and time to first flatus between these two groups (all P>0.05). There were no significant differences between the two groups with respect to postoperative complications rate (25.8% vs. 20.9%, P>0.05) and perioperative mortality (1.5% vs. 0.7%, P>0.05). However, minor surgery-related complication rate was higher in obese group (16.7%vs. 6.8%, P<0.05), mainly presented as delayed gastric emptying. There was no difference in perioperative mortality between the two groups (1.5% vs. 0.7%, P>0.05). Conclusions Although obesity prolongs the duration of laparoscopy-assisted radical gastrectomy , and increases the risk of minor surgery-related complications, it has no influence on the surgical safety.