超声刀在开放性胃癌根治术中的应用  

Usage of ultrasonically activated scalpel in radical resection of gastric carcinoma

作　　者：李刚[1] 顾荣民[1] 文旭[1] 韦达[1] 明学志[1] 陈环球[1] 

机构地区：[1]江苏省肿瘤医院普通外科胃肿瘤诊疗中心,南京医学博士210009

出　　处：《医学研究生学报》2010年第10期1050-1054,共5页Journal of Medical Postgraduates

基　　金：江苏省社会发展科技计划项目(BS2007010)

摘　　要：目的超声刀在腹腔镜胃癌根治术中被广泛使用,其与腹腔种植转移的关系尚缺乏循证医学证据,近年来,有学者将其应用于开放手术,文中探讨开放性胃癌根治术中使用超声刀的优缺点,及其与腹腔脱落细胞、腹腔灌洗液中癌胚抗原(carcinoembryonic antigen,CEA)mRNA的关系。方法回顾性分析2007年1月至2008年1月开放性胃癌根治术患者219例,其中应用超声刀组97例,常规手术组122例。分析比较临床病理、术前术后腹腔灌洗液中脱落细胞及应用RT-PCR法定性检测其中的CEA mRNA。结果与常规手术组相比,超声刀组具有节约手术时间(尤其对于肥胖患者)、减少出血量、增加手术清扫淋巴结个数、加快恢复术后进食等优点,且不增加腹腔脱落细胞阳性率、腹腔灌洗液CEA mRNA阳性率,术后2年生存率未见显著性差异。结论超声刀在开放性胃癌根治术中操作安全、使用便捷,不增加腹腔种植转移的发生率。Objective With the usage of ultrasonically activated scalpel in laparoscopic radical resection of gastric cancer,more and more surgeons used it in the open laparotomy.We aimed to explore the advantages and skills of using ultrasonically activated scalpel in radical resection of gastric cancer.Methods From January 2007 to January 2008,the data of 219 patients who were treated by radical gastrectomy using with or without the ultrasonically activated scalpel were analyzed retrospectively.Application of ultrasonic activated scalpel in 97 cases and 122 cases in control group using high-frequency electric knife.Observed the clinical pathology data,cytology and the level of CEA mRNA detected by RT-PCR in peritoneal lavage.Results Compared with the control group,the patient in using ultrasonically activated scalpel had shorter operation time,less amount of blood loss,more lymphy nodes,less days of recovery diet and the no difference of cumulative survival in two years after surgery,without increasing the positive rate of cytology and CEA mRNA-positive rate in peritoneal lavage.Conclusion Usage of ultrasonic scalpel in open radical gastrectomy is safe and easy.

关 键 词：超声刀 胃癌 胃癌根治术 

分 类 号：R735.2[医药卫生—肿瘤]