摘要
目的:探讨腹腔镜全胃切除术治疗胃上部癌的近期疗效及临床应用。方法:回顾分析2010年1月至2012年1月86例胃上部癌患者的临床资料,根据手术方式分为腹腔镜根治性全胃切除术组(A组,n=39)及腹腔镜根治性近侧胃大部分切除术组(B组,n=47),观察两组手术时间、淋巴结清扫率、术后并发症情况。结果:两组手术均顺利完成,无一例中转开腹,患者均康复出院。A组手术时间、淋巴结清扫率、术中出血量明显大于B组,差异有统计学意义(P<0.05),但出血量均较小,未输血。两组肛门排气时间,进食时间,下床活动时间,术后住院时间,吻合口漏、吻合口狭窄、肺部感染、腹腔感染等并发症发生率差异无统计学意义(P>0.05)。A组术后反流量较B组明显减少,差异有统计学意义(P<0.05)。结论:腹腔镜根治性全胃切除术治疗胃上部癌术后并发症较少,具有明显的抗反流效果,且微创优势明显,淋巴结清扫率高,值得临床推广。但与根治性全胃切除术相比,近、远期疗效尚缺乏大宗病例的对照研究,且远期疗效尚无对比研究。
Objective：To evaluate the short-term efficacy and clinical application of laparoscopic radical total gastrectomy for patients with proximal gastric cancers. Methods ：The clinical data of 86 patients with proximal gastric carcinoma from Jan. 2010 to Jan. 2012 were retrospectively analyzed. All patients were divided into 2 groups：laparoscopic radical total gastrectomy group （group A, n = 39 ） and laparoscopic radical proximal gastrectomy group （ group B, n = 47 ）. Harvested lymph nodes, operation time and postoperative complications were observed and statistically analyzed. Results：In this study, all operations were successful, and no patients were con- verted to iaparotomy. All the patients were safely discharged. The operation time, rate of lymph nodes harvested, intraoperative blood loss in group A were significantly greater than those in group B （ P 〈 0.05 ）. The blood loss was small and no transfusion was needed. The exhaust time, time of resuming an oral diet, ambulation and postoperative hospital stay, anastomotic leakage, anastomotic stenosis, pulmo- nary infection and intra-abdominal infection were not statistically different between the 2 groups （ P 〉 0.05 ）. The postoperative regurgi- tant volume of group A was fewer than that of group B （ P 〈 0.05 ）. Conclusions： Laparoscopic radical total gastrectomy has many ad- vantages in the therapy of proximal gastric cancer, such as few complications, obvious effect of against reflux, minimally invasion, and high rate of lymph node dissection. It deserves to be recommended in the clinical application. Compared with radical total gastrectomy, due to lack of large case-control study and comparative study, the short-term or long-term efficacy of laparoscopic radical total gastrecto- my is still uncertain.
出处
《腹腔镜外科杂志》
2014年第5期363-366,共4页
Journal of Laparoscopic Surgery
基金
国家科技部
财政部科技惠民计划(编号:2012GS620101)
甘肃省科技重大专项(编号:2011GS04390)
关键词
胃肿瘤
胃切除术
腹腔镜检查
近期疗效
Stomach neoplasms
Gastrectomy
Laparoscopy
Short-term efficacy
