中国医药
中國醫藥
중국의약
CHINA MEDICINE
2015年
6期
851-853
,共3页
胃癌根治术%腹腔镜%进展期胃癌
胃癌根治術%腹腔鏡%進展期胃癌
위암근치술%복강경%진전기위암
Radical gastrectomy%Laparoscopy%Advanced gastric cancer
目的 探讨腹腔镜辅助胃癌根治术和开腹胃癌根治术对远端进展期胃癌的疗效差异.方法 选取2012年1月至2013年1月于山西省肿瘤医院行腹腔镜辅助远端进展期胃癌根治术的36例患者(腹腔镜组)与同期行开腹远端进展期胃癌根治术的34例患者(开腹组)的临床资料进行回顾性分析.比较2组患者手术切口长度、手术时间、术中出血量、术后肛门首次排气时间、首次进食时间、术后住院时间、淋巴结清扫数目、术后并发症、术后病理诊断及随访情况.结果 与开腹组比较,腹腔镜组手术切口长度更短[(6.1 ±0.4)cm比(18.4 ±0.9)cm],手术时间更长[(254±29) min比(137±16) min],术中出血量更少[(85 ±26) ml比(139±34)ml],术后肛门首次排气时间更短[(3.3±0.6)d比(4.0±1.0)d],首次进食时间更短[(2.7±0.6)d比(5.2±0.6)d],差异均有统计学意义(均P ＜0.05).腹腔镜组发生肺部感染1例;开腹组发生切口脂肪液化、胃瘫、肺部感染各1例.2组患者切除标本上、下切缘均未见癌组织.腹腔镜组1例因脑出血死亡,1例肝转移,开腹组1例肝转移,1例双肺转移,余患者复查均未发现转移及复发征象.结论 腹腔镜辅助远端进展期胃癌根治术与开腹手术相比,具有手术创伤小、患者痛苦较小、术中出血少、术后恢复快等优势,且根治效果相当,是进展期胃癌的一种安全有效的治疗方法.
目的 探討腹腔鏡輔助胃癌根治術和開腹胃癌根治術對遠耑進展期胃癌的療效差異.方法 選取2012年1月至2013年1月于山西省腫瘤醫院行腹腔鏡輔助遠耑進展期胃癌根治術的36例患者(腹腔鏡組)與同期行開腹遠耑進展期胃癌根治術的34例患者(開腹組)的臨床資料進行迴顧性分析.比較2組患者手術切口長度、手術時間、術中齣血量、術後肛門首次排氣時間、首次進食時間、術後住院時間、淋巴結清掃數目、術後併髮癥、術後病理診斷及隨訪情況.結果 與開腹組比較,腹腔鏡組手術切口長度更短[(6.1 ±0.4)cm比(18.4 ±0.9)cm],手術時間更長[(254±29) min比(137±16) min],術中齣血量更少[(85 ±26) ml比(139±34)ml],術後肛門首次排氣時間更短[(3.3±0.6)d比(4.0±1.0)d],首次進食時間更短[(2.7±0.6)d比(5.2±0.6)d],差異均有統計學意義(均P ＜0.05).腹腔鏡組髮生肺部感染1例;開腹組髮生切口脂肪液化、胃癱、肺部感染各1例.2組患者切除標本上、下切緣均未見癌組織.腹腔鏡組1例因腦齣血死亡,1例肝轉移,開腹組1例肝轉移,1例雙肺轉移,餘患者複查均未髮現轉移及複髮徵象.結論 腹腔鏡輔助遠耑進展期胃癌根治術與開腹手術相比,具有手術創傷小、患者痛苦較小、術中齣血少、術後恢複快等優勢,且根治效果相噹,是進展期胃癌的一種安全有效的治療方法.
목적 탐토복강경보조위암근치술화개복위암근치술대원단진전기위암적료효차이.방법 선취2012년1월지2013년1월우산서성종류의원행복강경보조원단진전기위암근치술적36례환자(복강경조)여동기행개복원단진전기위암근치술적34례환자(개복조)적림상자료진행회고성분석.비교2조환자수술절구장도、수술시간、술중출혈량、술후항문수차배기시간、수차진식시간、술후주원시간、림파결청소수목、술후병발증、술후병리진단급수방정황.결과 여개복조비교,복강경조수술절구장도경단[(6.1 ±0.4)cm비(18.4 ±0.9)cm],수술시간경장[(254±29) min비(137±16) min],술중출혈량경소[(85 ±26) ml비(139±34)ml],술후항문수차배기시간경단[(3.3±0.6)d비(4.0±1.0)d],수차진식시간경단[(2.7±0.6)d비(5.2±0.6)d],차이균유통계학의의(균P ＜0.05).복강경조발생폐부감염1례;개복조발생절구지방액화、위탄、폐부감염각1례.2조환자절제표본상、하절연균미견암조직.복강경조1례인뇌출혈사망,1례간전이,개복조1례간전이,1례쌍폐전이,여환자복사균미발현전이급복발정상.결론 복강경보조원단진전기위암근치술여개복수술상비,구유수술창상소、환자통고교소、술중출혈소、술후회복쾌등우세,차근치효과상당,시진전기위암적일충안전유효적치료방법.
Objective To compared the effect of radical gastrectomy with laparoscopy-assisted and laparotomy in advanced gastric cancer.Methods Totally 70 patients with advanced gastric cancer from January 2012 to January 2013 were enrolled and divided into laparoscope group (36 cases) who underwent laparoscopy-assisted radical gastrectomy and laparotomy group (34 cases) who underwent open distal gastrectomy.The incision length,length of operation time,blood loss,time of gastrointestinal recovery and oral intake,length of hospitalization,number of lymph nodes dissected,postoperative complications,postoperative pathology,and follow-up were analyzed and compared between the two groups.Results Compared with laparotomy group,laparoscope group had shorter incision [(6.1 ± 0.4) cm vs (18.4 ± 0.9) cm],longer operation time [(254 ± 29) min vs (137 ±16) min],less blood loss [(85 ± 26) ml vs (139 ± 34) ml],less time spending in gastrointestinal recovery and oral intake group [(3.3 ± 0.6) d vs (4.0 ± 1.0) d,(2.7 ± 0.6) d vs (5.2 ± 0.6) d],with significant differences (all P ＜ 0.05).There were 1 case of pulmonary infection in laparoscope group,1 case of incision fat liquefaction,1case of gastroplegia and 1 case of pulmonary infection in laparotomy group.No cancer tissue was found on the cutting edge in both the two groups.One case in laparoscope group was dead due to cerebral hemorrhage.There was 1 case of hepatic metastasis in laparoscope group,1 case of hepatic metastasis and 1 case of pulmonary metastasis in laparotomy group.Conclusion Laparoscopy-assisted radical gastrectomy is safe in the advanced gastric cancer,with minimal trauma,less blood loss,less pain,faster recovery and similar efficacy compared with laparotomy.
