摘要
目的比较腹腔镜胰体尾切除术(LDP)与开腹胰体尾切除术(ODP)的短期临床疗效。方法回顾性分析2017年9月至2018年12月在中国医学科学院肿瘤医院胰胃外科行胰体尾切除术的161例胰体尾肿瘤患者的临床病理资料,根据手术方式将患者分为LDP组(43例)和ODP组(118例)。对比LDP组和ODP组患者的术前临床资料、术中相关指标、术后并发症、术后恢复指标、术前和术后炎症指标,分析短期临床疗效和安全性。结果LDP组和ODP组患者的术前临床特征差异无统计学意义(均P>0.05)。LDP组患者的术中出血量为(194.19±241.83)ml,明显少于ODP组[(315.17±295.94)ml,P<0.05];LDP组患者的术后排气时间为(3.00±0.72)d,明显短于OPD组[(4.05±0.97)d,P<0.001];LDP组患者的下床活动时间为(3.14±1.01)d,明显短于OPD组[(3.55±1.05)d,P<0.05];LDP组患者的术后进食时间为(3.88±1.61)d,明显短于OPD组[(5.11±1.56)d,P<0.001];LDP组患者的拔除引流管时间为(8.44±1.93)d,明显短于ODP组[(9.82±3.70)d,P<0.05];LDP组患者的术后住院时间为(9.65±3.57)d,明显短于ODP组[(11.99±6.57)d,P<0.05];LDP组患者的手术时间为(168.65±55.45)min,虽短于ODP组[(171.23±65.61)min],但差异无统计学意义(P>0.05)。LDP组患者非胰瘘相关并发症的发生率为16.3%,与ODP组患者的差异无统计学意义(11.0%,P>0.05);LDP组患者胰瘘的发生率为16.3%,与ODP组患者的差异无统计学意义(19.5%,P>0.05);LDP组总并发症的发生率为32.6%,与ODP组的差异无统计学意义(30.5%,P>0.05)。LDP组和ODP组患者术前和术后相关炎症指标的差异均无统计学意义(均P>0.05)。结论与ODP手术比较,LDP手术具有术中出血量少、术后恢复快、术后住院时间短等优势,并且不增加术后并发症的发生率和延长手术时间。LDP是安全、可行的手术方式,其短期临床效果优于ODP。
Objective To compare the short-term clinical effect between laparoscopic distal pancreatectomy(LDP)and open distal pancreatectomy(ODP).Methods We performed a retrospective study on 161 patients who underwent pancreatectomy between September 2017 to December 2018 in the Department of Pancreatic and Gastric Surgery,Cancer Hospital of Chinese Academy of Medical Sciences.According to the mode of operation,the patients were divided into the LDP group(n=43)and the ODP group(n=118).To compare the short-term clinical effect and safety between the LDP group and the ODP group,the preoperative clinical data,intraoperative related index,postoperative complication,postoperative recovery index,preoperative and postoperative inflammatory index were analyzed.Results The preoperative clinical characteristics between the LDP group and the ODP group were not statistically different(P>0.05).The intraoperative blood loss in LDP group was(194.19±241.83)ml,significantly less than(315.17±295.94)ml in ODP group(P<0.05),and the postoperative exhaust time in LDP group was(3.00±0.72)days,significantly shorter than(4.05±0.97)days in OPD group(P<0.001).The time to get out of bed in LDP group was(3.14±1.01)days,significantly shorter than(3.55±1.05)days in OPD group(P<0.05).The postoperative eating time in LDP group was(3.88±1.61)days,significantly shorter than(5.11±1.56)days in ODP group(P<0.001).The time of the drainage tube removal in LDP group was(8.44±1.93)days,significantly shorter than(9.82±3.70)days in ODP group(P<0.05).The postoperative hospital stay in LDP group was(9.65±3.57)days,significantly shorter than(11.99±6.57)days in ODP group(P<0.05).The mean operation time in LDP group was(168.65±55.45)min,shorter than(171.23±65.61)min in ODP group,but without significant difference(P>0.05).The incidences of non-pancreatic fistula-related complications in LDP group and ODP group were 16.3%and 11.0%,respectively,without statistical significance(P>0.05).The incidences of pancreatic fistula in LDP group and ODP group were 16.3%an
作者
李维坤
马福海
刘昊
李洋
马帅
康文哲
钟宇新
解亦斌
田艳涛
Li Weikun;Ma Fuhai;Liu Hao;Li Yang;Ma Shuai;Kang Wenzhe;Zhong Yuxin;Xie Yibin;Tian Yantao(Department of Pancreatic and Gastric Surgery,National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100021,China)
出处
《中华肿瘤杂志》
CAS
CSCD
北大核心
2020年第6期495-500,共6页
Chinese Journal of Oncology
基金
首都卫生发展科研专项(首发2018-2-4022)。
关键词
胰体尾肿瘤
腹腔镜
远端胰体尾切除术
短期临床效果
Pancreatic body and tail tumors
Laparoscopy
Distal pancreatectomy
Short-term clinical effect
