3D高清腹腔镜在腹腔镜辅助根治性全胃切除术中的应用  

Application of Three-dimensional High-definition Laparoscope in Laparoscope-assisted Radical Total Gastrectomy

作　　者：洪清琦[1] 罗琪[1] 黄正接[1] 李永文[1] 尤俊[1] 

机构地区：[1]厦门大学附属第一医院肿瘤中心胃肠外科,厦门361003

出　　处：《中国微创外科杂志》2015年第11期976-978,共3页Chinese Journal of Minimally Invasive Surgery

基　　金：福建省自然科学基金青年创新项目(2012D-52)

摘　　要：目的探讨3D高清腹腔镜在腹腔镜辅助根治性全胃切除术中的应用价值。方法选取我科2014年4月～2015年5月收治的胃上部癌43例,依据住院号单双号分别采用3D高清腹腔镜（3D组,21例）和2D高清腹腔镜（2D组,22例）行根治性全胃切除术,比较2组食管-空肠吻合口单针缝合时间、脾门清扫时间、总手术时间、术中失血量、淋巴结清扫数、总住院费用等方面的差异。结果食管-空肠吻合口单针缝合时间3D组[（32.3±4.3）s]〈2D组[（49.5±5.5）s,t=-11.400,P=0.000）;脾门清扫时间3D组[（28.6±5.0）min]〈2D组[（38.5±4.6）min,t=-6.811,P=0.000];总手术时间2组差异无显著性[3D组（198.7±14.9）min,2D组（205.5±18.5）min,t=-1.320,P=0.194];术中失血量3D组[（54.3±9.0）ml]〈2D组[（76.8±22.5）ml,t=-4.349,P=0.000];淋巴结清扫数2组差异无显著性[3D组（27.3±8.1）枚,2D组（24.6±8.3）枚,t=1.082,P=0.286];总住院费用2组差异无显著性[3D组（6.31±0.51）万元,2D组（6.20±0.50）万元,t=0.685,P=0.497）。结论 3D比2D高清腹腔镜能提供更清晰的三维立体视觉效果,良好的景深度,实现精确操作,缩短单针缝合时间和脾门清扫时间,并减少术中出血量,且未明显增加住院费用。Objective To investigate the clinical value of three-dimensional（ 3D） high-definition（ HD） laparoscope in laparoscope-assisted radical total gastrectomy. Methods From April 2014 to May 2015,43 patients diagnosed as upper gastric cancer in our hospital were divided into two groups according to their admission number（ odd or even number）. The two groups underwent either radical total gastrectomy with 3D HD laparoscope assistance（ 3D group,21 cases） or 2D HD laparoscope assistance（ 2D group,22 cases）. The time for single suture of esophago-jejunum anastomotic stoma,time for splenic hilar lymphadenectomy,duration of operation,intra-operative blood loss,lymph node number of lymphadenectomy,and costs during hospitalization were compared between the two groups. Results The average time for single suture of esophago-jejunum anastomotic stoma in the 3D group was（ 32. 3 ± 4. 3） s,which was significantly shorter than that in the 2D group [（ 49. 5 ± 5. 5） s,t =- 11. 400,P = 0. 000].The average time for splenic hilar lymphadenectomy was（ 28. 6 ± 5. 0） min in the 3D group and（ 38. 5 ± 4. 6） min in the 2D group,with significant difference（ t =- 6. 811,P = 0. 000）. The average operation duration was（ 198. 7 ± 14. 9） min in the 3D group and（ 205. 5 ± 18. 5） min in the 2D group,without significant difference（ t =- 1. 320,P = 0. 194）. The average intraoperative blood loss was significantly less in the 3D group than that in the 2D group [（ 54. 3 ± 9. 0） ml vs.（ 76. 8 ± 22. 5） ml,t =- 4. 349,P = 0. 000].The average lymph node number of lymphadenectomy in the 3D group was（ 27. 3 ± 8. 1） nodes,which was more than that in the 2D group（ 24. 6 ± 8. 3 nodes）,but without significant difference（ t = 1. 082,P = 0. 286）. The mean hospitalization costs were（ 6. 31 ±0. 51） × 104 RMB yuan in the 3D group,which were not significantly higher than that in the 2D group [（ 6. 20 ± 0. 50） × 104 RMB yuan,t = 0. 685,P = 0. 497]. Conclusion As compared with 2D la

关 键 词：3D 2D 腹腔镜 根治性全胃切除术 胃癌 

分 类 号：R735.2[医药卫生—肿瘤]