微创远端胃癌手术结合D2淋巴结清扫治疗胃癌的临床疗效分析  

Analysis on clinical efficacy of minimally invasive distal gastric cancer surgery combined with D2 lymph node dissection

作　　者：李著[1] 邓杰[1] 孙坚[1] 毕胜[1] 刘午斌 LI Zhu;DENG Jie;SUN Jian;BI Sheng;LIU Wu-bin(Department of General Surgery,No.169 Hospital of PLA（Xiangnan Hospital Affiliated to Hunan Normal University）,Hengyang Hunan 421002,China)

机构地区：[1]解放军第169医院(湖南师范大学附属湘南医院)普通外科,湖南衡阳421002

出　　处：《局解手术学杂志》2018年第5期346-349,共4页Journal of Regional Anatomy and Operative Surgery

摘　　要：目的探讨微创远端胃癌手术结合D2淋巴结清扫治疗胃癌的临床疗效。方法选择我院2010年9月至2012年9月收治的胃癌手术患者95例,剔除2例腹腔中转开腹患者共计纳入93例作为研究对象。按照手术方式的不同将93例患者分为观察组43例和对照组50例。观察组采用微创远端胃癌手术结合D2淋巴结清扫,对照组采用开腹手术结合D2淋巴结清扫。比较2组患者术中出血量、下床活动时间、手术时间、住院时间、淋巴结清扫数目、术后并发症发生情况,及随访1年、3年和5年复发转移和死亡情况。结果观察组术中出血量少于对照组,下床活动时间早于对照组,住院时间短于对照组,2组比较差异有统计学意义(P<0.05);而2组手术时间比较差异无统计学意义(P>0.05)。2组清扫第一站淋巴结数、第二站淋巴结数和清扫淋巴结总数比较差异无统计学意义(P>0.05)。观察组术后并发症发生率(6.98%)低于对照组(22.00%),2组比较差异有统计学意义(P<0.05)。2组患者随访1年、3年和5年复发转移率和病死率均较低,差异无统计学意义(P>0.05)。结论微创远端胃癌手术结合D2淋巴结清扫对胃癌患者临床疗效显著,术中出血量少,术后恢复快,并发症少,且远期随访复发转移和死亡少。Objective To explore the clinical effect of minimally invasive distal gastric cancer surgery combined with D2 lymph node dissection. Methods From September 2010 to September 2012,95 cases of gastric cancer surgically treated from our hospital were selected.Among them,2 cases were converted to laparotomy by abdominal cavity,and a total of 93 patients were included in the study. According to different surgical methods,there were 43 cases in the observation group and 50 cases in the control group. The observation group was treated with minimally invasive distal gastric cancer surgery combined with D2 lymph node dissection,and the control group was treated with open surgery combined with D2 lymph node dissection. The bleeding volume,ambulation time,operative time,hospitalization time,lymph node dissection and postoperative complications were compared between the two groups. The recurrence,metastasis and mortality during 1 year,3 years and 5 years follow-up were also compared. Results The bleeding volume in the observation group was less than that in the control group,and the off-bed activity occurred earlier than that in the control group. The hospitalization time was shorter in the observation group than in the control group（ P〈0. 05）,but there was no significant difference in operative time between the two groups（ P 〉0. 05）. There was no statistical difference between the number of lymph nodes in the first station,the number of lymph nodes in second stations and the total number of lymph nodes in the two groups（ P 〉0. 05）. The incidence of postoperative complications in the observation group（ 6. 98%）was lower than that ofthe control group（ 22. 00%）（ P 〈0. 05）. The two groups were followed up for 1,3 and 5 years,and the recurrence rate and mortality rate were low（ P〉0. 05）. Conclusion minimally invasive distal gastric cancer surgery combined with D2 lymph node dissection has significant clinical effect,less blood loss,quicker postoperative recovery and fewer complications,as wel

关 键 词：微创远端胃癌手术 D2淋巴结清扫 胃癌 疗效 随访 

分 类 号：R735.2[医药卫生—肿瘤] R656.61[医药卫生—临床医学]