全腹腔镜下远端胃癌根治胃十二指肠三角吻合术在远端胃癌根治中的价值及安全性  

Value and safety of laparoscopic radical gastrectomy for distal gastric cancer in radical gastrectomy for distal gastric cancer

作　　者：郑小平 周兴华 朱卫国 杨伟聪 巢江玲 

机构地区：[1]广东省佛冈县人民医院普外科,广东佛冈511600

出　　处：《中国医药科学》2017年第16期213-216,共4页China Medicine And Pharmacy

摘　　要：目的评价应用全腹腔镜下远端胃癌根治术和胃十二指肠三角吻合术在远端胃癌根治术中的效果和安全性。方法选择2015年3月~2016年3月间于我院拟行手术治疗的远端胃癌患者86例,根据就诊顺序按随机数字表法分为全腹腔镜组43例和剖腹组43例,分别采用全腹腔镜远端胃癌根治术联合胃十二指肠三角吻合术和剖腹下远端胃癌根治术联合BillrothⅠ式胃十二指肠吻合术。比较两组患者术中情况(总手术时间、吻合时间、淋巴结清扫数和肿瘤切缘距离)和术后情况(术后疼痛、首次下床活动时间、肛门排气时间、首次进食时间和术后住院时间)以及相关手术并发症的发生率。结果所有患者均成功完成手术,术后随访半年未出现复发、转移和死亡病例。全腹腔镜组和剖腹组患者的平均手术时间分别为(172.2±17.3)min和(173.6±16.1)min,全腹腔镜组吻合时间显著低于剖腹组(P<0.05),两组间淋巴结清扫数目和肿瘤切缘距离间均无统计学意义(P>0.05)。全腹腔镜组患者的术后疼痛程度、首次下床时间、肛门排气时间、首次进食时间和术后住院时间显著低于剖腹组(P<0.05)。全腹腔镜组的并发癌症发生率为9.30%(4/43)显著低于剖腹组的25.58%(11/43)(P<0.05)。结论在远端胃癌根治术中应用全腹腔镜下远端胃癌根治术和胃十二指肠三角吻合术,能够显著缩短手术吻合和住院时间,具有加好的吻合效果和更低的并发症发生率,疼痛程度轻,下床活动早,术后恢复快,值得推广。Objective To evaluate the value and safety of laparoscopic radical gastrectomy for distal gastric cancer in radical gastrectomy for distal gastric cancer. Methods 86 patients with distal gastric cancer underwent surgical treatment in our hospital from March 2015 to March 2016 were selected and divided into totally laparoscopic group （43 cases） and laparotomy group （43 cases） according to random number method.They were treated with laparoscopic radical gastrectomy combined with gastro duodenal triangle anastomosis and distal gastrectomy for distal gastrectomy combined with Billroth I gastrectomy,respectively,The situation in operation （total operation time, operation time,lymph nodes and tumor margins） and postoperative （postoperative pain,hospitalization time for the first time out of bed activity time,anal exhaust time,eating for the first time and postoperative） and the incidence of surgical complications of the two groups were compared. Results All patients completed the operation successfully. The patients were followed up for 6 months without recurrence,metastasis or death.The average operation time of the laparoscopic group and the laparotomy group were （172.2＋17.3）min and （173.6＋16.1）min.The time of anastomosis in laparoscopic group was lower than that in laparotomy group （P 〈 0.05）.There was no statistical difference between the two groups in the number of lymph node dissection and the margin of tumor resection （P 〉 0.05）.The degree of postoperative pain, the first ambulation time,the anal exhaust time,the first feeding time and the postoperative hospital stay in the laparoscopic group were significantly lower than those in the laparotomy group （P 〈 0.05）.The rate of concurrent cancer in the laparoscopic group was 9.30%（4/43）,which was significantly lower than that in the laparotomy group with 25.58% （11/43） （P 〈 0.05）. Conclusion Laparoscopic radical gastrectomy for distal gastric cancer and anastomosis of gastroduodenal triangle in radical gast

关 键 词：远端胃癌 腹腔镜 剖腹手术 胃十二指肠吻合术 

分 类 号：R735.2[医药卫生—肿瘤]