基层医院腹腔镜辅助小切口胃癌根治术中采用顺向式模块化淋巴结清扫的体会  

Effect of Clockwise Modularized Lymphadenectomy in Laparoscopic-assisted Radical Gastrectomy with Small Incision

作　　者：李升 朱一宁[2] 王君[2] LI Sheng;ZHU Yi-ning;WANG Jun(The People＇s Hospital of Bobai County,Yulin 537600,Guangxi,China;The First People＇s Hospitall of Yulin,Yulin 537006,Guangxi,China)

机构地区：[1]玉林市博白县人民医院,广西玉林537600 [2]玉林市第一人民医院,广西玉林537006

出　　处：《中国现代手术学杂志》2018年第3期170-173,共4页Chinese Journal of Modern Operative Surgery

摘　　要：目的探究顺向式模块化淋巴结清扫在胃癌微创外科治疗中的应用效果。方法选取2017年3月至2018年1月在我院接受顺向式模块化D2淋巴结清扫的腹腔镜辅助小切口胃癌根治术的患者16例作为实验组,再选取2016年1月至2017年2月行传统D2淋巴结清扫的腹腔镜辅助小切口胃癌根治术的21例患者作为对照组,进行病例对照研究。对照组患者在行腹腔镜辅助小切口胃癌根治术时,采用传统淋巴结清扫方法。实验组患者在上述治疗的基础上,行顺向式模块化淋巴结清扫[1]。分别比较两组患者的手术时间、术中出血量、淋巴结清扫总数;并比较两组并发症的发生率。结果实验组患者的手术时间为(195.29±43.56)min,明显短于常规组(224.34±46.83)min(P<0.05);实验组术中出血量为(108.42±57.89)ml,明显少于常规组(156.56±61.47)ml(P<0.05);两组患者淋巴结清扫总数及患者术后腹腔出血、吻合瘘、肠梗阻、胰腺炎等并发症发生率比较均无统计学意义(P>0.05)。结论顺向式模块化淋巴结清扫能减少腹腔镜辅助小切口胃癌根治术的手术时间,减少术中出血量,且不对患者预后产生不良影响;是安全可行的。Objective To explore the effect of clockwise modularized lymphadenectomy in minimally invasive surgery for gastric cancer. Methods From March 2017 to January 2018, 16 cases of laparoscopic-assisted small incision radical gastrectomy with D2 lymph node dissection in our hospital were selected as the experimental group, and 21 cases of laparoscopic-assisted small incision radical gastrectomy from January 2016 to February 2017 were selected as the control group. A case-control study was conducted. Patients in the control group received conventional lymph node dissection during laparoscopic assisted small incision radical gastrectomy. On the basis of the above treatments, patients in the experimental group underwent clockwise modularized lymphadenectomy. Operative time, intraoperative blood loss and total number of lymph node dissection between the two groups were compared, and the incidence of complications in the two groups were compared as well. Results Operation time in the experimental group was （195.29±43.56） min, which was obviously shorter than the conventional group （224.34±46.83） min （ P 〈0.05）, and the blood loss in the experimental group was （108.42±57.89） ml, which was obviously less than （156.56±61.47） ml of the conventional group（ P 〈0.05）. There was no significant difference in the total number of lymph node dissection in the two groups （ P 〉0.05）. And the incidence of complications such as fistula, intestinal obstruction and pancreatitis was not statistically significant （ P 〉0.05）. Conclusions The clockwise modularized lymphadenectomy can reduce operation time of laparoscopic-assisted small incision radical gastrectomy, reduce the amount of intraoperative bleeding with no influence on the postoperative effects. It is safe and feasible.

关 键 词：顺向式模块淋巴结清扫 胃肿瘤 腹腔镜辅助 

分 类 号：R713.4[医药卫生—妇产科学]