摘要
目的：比较腹腔镜全胃切除术（全胃Roux-Y切除术）、近侧胃切除术治疗胃上部癌的临床效果及预后影响。方法：回顾性分析我院胃肠外科腹腔镜治疗的137例胃上部癌患者的临床资料及随访资料,其中全胃Roux-Y切除术71例（A组）近侧胃切除术66例（B组）,比较两组手术及预后情况。结果：A组手术时间、术中出血量、术后排气时间、术后进食流质时间均显著长于B组（P〈0.05）,但A组术中清扫淋巴结数目多于B组（P〈0.05）,两组术后卧床时间、住院时间差异无统计学意义（P〉0.05）。A组吻合口狭窄、吻合口瘘、肺部感染、腹腔感染、肠梗阻发生率与B组比较差异无统计学意义（P〉0.05）;术后反流性食管炎发生率显著低于B组,差异具有统计学意义（P〈0.05）。A组3年生存率显著高于B组（63.38%vs43.94%,χ2=5.205,P=0.023）;A组中位生存时间显著长于B组（32个月vs29个月,χ2=5.802,P=0.016）。结论：腹腔镜全胃Roux-Y切除术治疗胃上部癌疗效更佳,患者生存时间更长。
Objective： Comparison of iaparoscopic total gastrectomy （a full stomach Roux-Y resection）, proximal gastrectomy of gastric cancer clinical efficacy and prognosis. Methods： A ret rospective analysis of the clinical data and follow-up data of our hospital department of gastrointestinal surgery, the laparoscopic treatment of 137 cases of upper gastric cancer patients, which fullstomach Roux-Y resection 71 cases（group A）, nearly gastrectomy in 66 cases（group B）, compared two groups of surgery and prognosis. Results： A group of operation time, intraoperative bleeding volume, postoperative exhaust time, postoperative eating liquid time were significantly longer than those of group B （P〈 0.05）, but patients in group a underwent dissection lymph node number more than those in group B （P 〈 0.05）, two groups of postoperative bed time, hospitalization time differences had no statistical significance（P〉 0.05）. A group of anastomotic stenosis, anastomotic fistula and pulmonary infection, abdominal cavity infection, intestinal obstruction occurred rate of group A and group B difference no statistical significance （P 〉 0.05）; postoperative reflux esophagitis inci- dence was significantly lower than that in group B, and the difference is statistically significant （P〈 0.05）. The 3 year survival rate of A group was significantly higher than that of B group （63.38% vs 43.94%, χ2=5.205, P=0.023）; The median survival time of A group was significantly longer than that of B group （32 months vs 29 months, χ 2=5.802, P=0.016）. Conclusion： Laparoscopic total gas- trectomy for the treatment of upper gastric cancer is better, and the survival time of patients is longer than that of the patients with Roux-Y.
出处
《中国现代普通外科进展》
CAS
2016年第6期443-445,450,共4页
Chinese Journal of Current Advances in General Surgery
