摘要
目的:探索腹腔镜远端胃癌根治术不放置胃管和腹腔引流管等的安全性和可行性。方法:回顾性分析2019年11月~2020年4月50例行腹腔镜远端胃癌根治术患者的临床资料。其中30例患者(对照组),术中均按常规方式置管(胃管、腹腔引流管及导尿管),记录患者术后胃管及腹腔引流管引流液的性状及引流量。20例患者(无管化组),术后未留置胃管、腹腔引流管,术后1天拔除导尿管。分别比较对照组与无管化组患者的术后恢复情况、术后并发症等之间的差异。结果:无管化组术后VAS疼痛评分、术后镇痛药使用剂量、术后首次下床时间以及术后住院时间优于对照组(P<0.05)。无管化组患者咽痛发生率(25.00%)低于对照组(60.00%)(P<0.05),两组患者发热、肺部感染等并发症发生率差异均无统计学意义(P>0.05)。结论:腹腔镜远端胃癌根治术无管化是一种安全可行的快速康复外科措施之一,可有条件地根据术中情况选择性使用。
Objective:To investigate the safety and feasibility of laparoscopic distal radical gastrectomy for patients with gastric cancer without use of nasogastric tube or abdominal drainage.Methods:Clinical data were retrospectively analyzed in 50 cases of gastric cancer undergone laparoscopic distal radical gastrectomy between November 2019 to April 2020 in our hospital.The cases were divided into control group(n=30,managed by routine drainage tube placement including nasogastric tube,abdominal drainage tube and urinary catheter during surgery),and tube-free group(n=20,without use of nasogastric tube or abdominal drainage,and urinary catheter was removed at the first day after surgery).The data maintained in control group included characteristics of the drained fluid and drainage volume of nasogastric tube and abdominal drainage tube.The two groups were compared regarding the difference in postoperative recovery and complications.Results:Patients in the tube-free group had lower VAS pain scoring and postoperative analgesic dosage,earlier off-bed activities after surgery and shortened postoperative hospital stay as well as lower incidence of pharyngalgia than those in the control group(all P<0.05),whereas the two groups remained insignificant in incidences of fever and pulmonary infection(P>0.05).Conclusion:Tube-free management can be one of the quick rehabilitations for patients with gastric cancer undergoing laparoscopic distal radical gastrectomy,and be optionally recommended in clinical settings.
作者
史蕾
许友
洪亮
吴泽晖
刘刚
史良会
SHI Lei;XU You;HONG Liang;WU Zehui;LIU Gang;SHI Lianghui(Operating Room,The First Affiliated Hospital of Wannan Medical College,Wuhu 241001,China)
出处
《皖南医学院学报》
CAS
2021年第1期89-91,95,共4页
Journal of Wannan Medical College
基金
安徽省高校协同创新项目(GXXT-2019-014)。
关键词
胃癌
腹腔镜手术
无管化
围手术期管理
gastric cancer
laparoscopic radical gastrectomy
tube-free drainage
perioperative management
