手辅助腹腔镜胃癌根治术的临床效果观察  

Clinical observation of hand-assisted laparoscopic radical resection of gastric cancer

作　　者：陈楷[1] 李恩[1] 李志旺[1] 

机构地区：[1]广东省梅州市人民医院胃肠外科,514011

出　　处：《中华普外科手术学杂志（电子版）》2016年第1期23-26,共4页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

摘　　要：目的探讨手辅助腹腔镜胃癌根治性切除术的临床可行性和效果。方法回顾性分析2011年10月至2014年10月收治的132例胃癌根治性手术患者的临床资料,根据手术方式分为手辅助组(采用手辅助腹腔镜手术治疗41例)、腹腔镜组(采用腹腔镜辅助手术46例)、开腹组(采用传统开腹手术治疗45例)。使用SPSS17.0统计软件分析,三组患者的术中、术后指标以(x珋±s)表示,三组组间两两比较采用LSD-t检验;术后并发症率比较采用卡方检验。P<0.05表示差异具有统计学意义。结果三组患者的手术时间、切口长度、术中出血量、清扫淋巴结数目、术后肛门排气时间、下床活动时间、术后住院时间指标比较差异均具有统计学意义(P<0.05);腹腔镜组的手术时间(192.4±16.6)min长于其他两组(P=0.039);手辅助组的术中出血量(229.5±44.2)ml显著小于其他两组(P=0.001);手辅助组和腹腔镜组的术后肛门排气时间、下床活动时间、术后住院时间显著的短于开腹组患者(P<0.05);手辅助组术中共清扫淋巴结(17.8±2.1)枚与开腹组相当,但显著的高于腹腔镜组(P=0.035)。三组患者的术后并发症发生率差异无统计学意义(χ2=1.846,P=0.397)。结论手辅助腹腔镜胃癌根治性切除术具有腹腔镜手术的微创、术后恢复快的特点,同时具有开腹手术的手术时间短、可充分发挥手的灵巧性及触觉、术中淋巴结清扫较为彻底的优点。Objective To explore the clinical outcome and feasibility of hand-assisted laparoscopic radical resection of gastric cancer. Methods Clinical data of 132 patients who had undergone gastric cancer radical surgery from October 2011 to October 2014 were analyzed retrospectively. According to operative modes, 132 patients were divided into hand-assisted group （hand-assisted laparoscopic surgery in 41 patients ）, laparoscopic group （conventional laparoseopic surgery in 46 ） and laparotomy group （traditional open surgery in 45 ）. Statistical analysis was performed by using SPSS17. 0 software. Measurement data of the three groups including intraoperative and postoperative indexes were presented as mean ＋ SD and examined by pairwise comparison with LSD-t test. Postoperative complication rate was compared by the Chi-square test （ P 〈 0.05 ）. Results There were significant differences in operation time, incision length, intraoperative blood loss, number of harvested, lymph nodes, postoperative anal exhaust time, ambulation time and postoperative hospitalization （ P 〈 0.05 ） between the 3 groups. The operation time in the laparoscopic group [ （ 192.4 ± 16.6） mini was longer than that in the other two groups （P = 0. 039）. The amount of blood loss was less in the hand-assisted group （229.5 ＋ 44.2） ml than in the other two groups （P = 0. 001 ）. Postoperative anal exhaust time, ambulation time and postoperative hospitalization in the hand-assisted laparoscopic group were shorter than those in the laparotomy group （P 〈 0.05 ）. There was no significant difference in harvested lymph nodes between the hand-assisted laparoscopic group （ 17.8 ± 2.1 ） and laparotomy group. But it was significantly higher than that in the laparoscopic group （ P = 0.035）. There was no significant difference in postoperative complications between the 3 groups X2 =1. 846, P = 0. 397）. Conclusion Fast recovery and minimal invasion could be achieved in hand-assisted laparoscopic radical resectio

关 键 词：胃肿瘤 腹腔镜检查 剖腹术 胃切除术 

分 类 号：R735.2[医药卫生—肿瘤]