进展期胃肠癌根治术传统与刮吸法淋巴结清扫的对比研究  

Comparative study on the conventional dissection and curettage-aspiration dissection in lymph node dissection for advanced gastrointestinal cancer

作　　者：陈晓鹏[1] 张国政[2] 李树仁[1] 张帆[3] 王东[1] 王冠男[1] 房淑彬[1] 李涛[1] 

机构地区：[1]皖南医学院弋矶山医院普外科,安徽芜湖241001 [2]皖南医学院弋矶山医院内镜室,安徽芜湖241001 [3]皖南医学院弋矶山医院病理科,安徽芜湖241001

出　　处：《中国实用外科杂志》2009年第10期844-846,共3页Chinese Journal of Practical Surgery

基　　金：安徽省临床医学重点学科项目基金(05A016)

摘　　要：目的比较传统解剖法和刮吸解剖法在进展期胃癌和大肠癌(简称胃肠癌)淋巴结清扫术中的效率。方法皖南医学院弋矶山医院2004年1月至2007年8月将收治的97例进展期胃肠癌病人随机分为传统手术组和刮吸手术组,分别统计两组手术时间、出血量、输血量、清除淋巴结数和术后随访情况。结果传统手术组和刮吸手术组平均手术时间分别为203.62min和209.60min;两组平均出血量分别为330.64mL和245.00mL,输血者平均输血量分别为683.33mL和504.50mL;平均每例清除淋巴结数分别为11.60枚和17.48枚。两组分别有39例和41例得到平均3年的随访,肿瘤复发率分别为48.72%和26.83%,3年存活率分别为56.41%和75.61%。结论刮吸解剖法可提高进展期胃肠癌淋巴结清扫程度和清扫效率,减少出血量;并降低肿瘤复发率,延长病人生存时间。刮吸法淋巴结清扫应掌握多功能手术解剖器的结构特点及其操作技巧。Objective To compare the effectiveness of the conventional dissection and curettage-aspiration dissection in lymph node dissection for advanced gastrointestinal cancer. Methods Ninety-seven patients with advanced gastrointestinal cancer admitted between January 2004 and August 2007 at Yijishan Hospital of Wannan Medical College were randomly divided into the conventional surgery group （CS group） and the curettage-aspiration surgery group （CA group）. The operation time, intraoperative hemorrhage quantity, blood transfusion amount, the number of cleared lymph node and postoperative data of follow-up were collected. Results The average surgery time was 203.62 mins in CS group and 209.60 mins in CA group, respectively. The intraoperative hemorrhage quantity was 330.64 and 245.00 mL with the blood transfusion amount 683.33 and 504.50 mL, respectively. The average number of cleared lymph node was 11.60 and 17.48, respectively. The follow-up time was 17-60 months, with an average of 36 months. The tumor recun＇ence rates in CS group and CA group were 48.72% （19/39） and 26.83% （11/41）, respectively, and 3-year survival rates were 56.41% and 75.61%, respectively. Conclusion Curettage-aspiration dissection may improve the extent and effectiveness of lymph node dissection for advanced gastrointestinal cancer, reduce the hemorrhage quantity, decrease the tumor recurrence rate and lengthen the live time of patients.

关 键 词：刮吸解剖法 胃癌 结直肠癌 淋巴结清扫术 

分 类 号：R6[医药卫生—外科学]