摘要
目的对比腹腔镜和传统开腹术对胃癌的治疗效果,比较两种手术方式对患者术后复发和炎症反应水平的影响.方法回顾性分析2015年3月至2016年3月在我院接受手术治疗的胃癌患者的临床资料,根据其手术方式分为腹腔镜组和传统开腹组.观察两组患者围手术期一般情况和炎症反应水平,比较两组患者1年后复发率和肿瘤标志物水平的差异.结果腹腔镜组患者术中出血量较开腹组少,住院时间较开腹组短,两组患者手术时间无明显差别;腹腔镜组患者术后肛门排气时间、进食时间和下床时间均较开腹组短;两组患者手术前炎症因子水平无差别,术后3d,开腹组患者C反应蛋白(CRP)、白细胞介素(IL)-18和IL-6水平高于腹腔镜组;两组患者术后吻合口瘘、吻合口狭窄和术后1年复发率无明显差别,腹腔镜组切口感染发生率低于开腹组;两组患者手术前和手术后1年肿瘤标志物水平均无明显差别.结论腹腔镜和传统开腹术对胃癌术后复发率和肿瘤标志物水平无明显影响,均有较好的效果,但腹腔镜组创伤小,手术时间短,炎症反应轻,具有更好的应用价值.
Objective To compare the therapeutic efficacy of laparoscopic surgery vs conventional laparotomy in gastric cancer,and to compare the impacts of the two surgical methods on postoperative recurrence and inflammatory response levels.Methods The clinical data of patients with gastric cancer,who underwent surgery in our hospital between March 2015 and March 2016,were retrospectively analyzed.According to the surgical methods,all patients were divided into laparoscopy group and conventional laparotomy group.The perioperative general condition and inflammatory response in the two groups were determined.The differences in the recurrence rate and levels of tumor biomarkers at 1 year after the surgery were compared between the two groups.Results The laparoscopy group experienced less intraoperative blood loss and shorter length of hospital stay compared with the laparotomy group.There was no significant difference in the operative time between the two groups.The time to anal exhaust,oral feeding and ambulation in the laparoscopy group were shorter than those in the laparotomy group.There were no differences in the levels of inflammatory factors at baseline between the two groups.At 3 days after the surgery,the levels of CRP,IL-18 and IL-6 in the laparotomy group were higher than those in the laparoscopy group.There were no significant differences in postoperative anastomotic fistula,anastomotic stenosis and recurrence rate at 1 year after the surgery.The incidence of incision infection in the laparoscopy group was lower than that in the laparotomy group.There were no significant differences in the levels of tumor biomarkers between the two groups at baseline and at 1 year after the surgery.Conclusion Both laparoscopic surgery and conventional laparotomy for gastric cancer show no significant impact on the postoperative recurrence rate and levels of tumor biomarkers,and result in good outcomes.Laparoscopic surgery shows less trauma,short operative time,and mild inflammatory reaction,which may better favor the clinical use.
作者
胡亚男
李朝辉
Hu Yanan;Li Zhaohui(Department of Anesthesiology,Luoyang Municipal Central Hospital,Zhengzhou University,Luoyang,Henan 471000,China;Department of Gastrointestinal Surgery,Luoyang Municipal Central Hospital,Zhengzhou University,Luoyang,Henan 471000,China)
出处
《中华生物医学工程杂志》
CAS
2019年第4期499-503,共5页
Chinese Journal of Biomedical Engineering
关键词
胃癌
腹腔镜
炎症因子
复发
肿瘤标志物
Gastric cancer
Laparoscopy
Inflammatory factors
Recurrence
Tumor biomarkers
