摘要
目的探讨肥胖胃癌病人行腹腔镜胃癌根治术的可行性及近期疗效。方法福建医科大学附属协和医院胃外科自2007年5月至2010年6月,对166例肥胖胃癌病人行根治性手术,对比分析腔镜组与开腹组病人的术中和术后情况、并发症、淋巴结清扫数目及近期生存差异。结果腹腔镜手术81例(腔镜组),开腹手术85例(开腹组)。腔镜组与开腹组的手术时间差异无统计学意义(P>0.05);腔镜组术中出血量、术中及术后输血率,术后第1天白细胞增加数,体温恢复时间,肛门排气时间及术后住院时间均少于开腹组,差异有统计学意义(P<0.05)。腔镜组与开腹组术后并发症发生率分别为17.2%和20.0%,差异无统计学意义(P>0.05)。两组平均淋巴结清扫数目差异无统计学意义(P>0.05)。157例(94.5%)获得2～39个月随访,中位随访时间为19个月,两组的生存曲线差异无统计学意义(P>0.05)。结论腹腔镜辅助胃癌根治术应用于肥胖胃癌病人是安全可行的,具有微创优势,并能满足肿瘤根治的要求。
Objective To study the feasibility and short-term efficacy of laparoscopic radical gastrectomy for obese patients with gastric cancer. Methods From May 2007 to June 2010, 166 obese patients with gastric cancer were performed radical resection in the Department of Gastric Surgery of Fujian Medical University Union Hospital. The differences of intraoperative and postoperative situation, postoperative complications, number of resected lymph nodes and short-term survival rates between laparoscopy and open gastrectomy group were analyzed. Results Among patients, 81 patients received lapamscopy-assisted gastrectomy （LAG group） and 85 patients underwent open gastrectomy （OG group）. There was no significant difference in the operation time between the two groups （P〉0.05）. In the aspects of intraoperative blood loss, rate of blood transfusion, increased number of leukocyte on the first postoperative day, time of temperature recovery, first flatus and postoperative hospital stays, the LAG group showed distinctive advantage than the OG group with the significant difference statistically （P〈0.05）. The rate of postoperative complications in LAG group and OG group were 17.2% and 20.0% and the difference was not significant （P〉0.05）. The difference of the mean number of retrieved lymph nodes between two groups was not significant （P〉0.05）. One hundred and fifty-seven patients （94.5%） were followed up for 2 to 39 months. The median time was 19 months. As for the survival curves, the survey showed there was no significant difference between two groups （P〉0.05）. Conclusion Laparoscopy-assisted radical gastrectomy is safe and feasible for obesity patients, which presents the superior character of minimal invasion and can achieve oncologic radical effect.
出处
《中国实用外科杂志》
CSCD
北大核心
2011年第8期681-683,共3页
Chinese Journal of Practical Surgery
关键词
胃癌
腹腔镜
肥胖
淋巴结清扫
gastric cancer
laparoscopy
obesity
lymphadenectomy
