伴发疾病对原发性胃癌腹腔镜手术患者腹部并发症发病率的影响  

Effect of concomitant diseases on the incidence of abdominal complications in patients with primary gastric cancer undergoing laparoscopic surgery

作　　者：王伟伟[1] 张建生[1] 吴会国[1] 何志国[1] Wei-wei Wang;Jian-sheng Zhang;Hui-guo Wu;Zhi-guo He(Department of General Surgery,Baodi District People’s Hospital(Baodi Clinical College of Medical University of Tianjin),Tianjin 301800,China)

机构地区：[1]天津市宝坻区人民医院(天津医科大学宝坻临床学院)外二科,天津301800

出　　处：《中国内镜杂志》2018年第10期64-67,共4页China Journal of Endoscopy

摘　　要：目的探究伴发疾病对原发性胃癌腹腔镜手术患者腹部并发症发病率的影响。方法回顾性分析2015年1月-2017年1月该院收治的138例行腹腔镜辅助胃癌根治术治疗后发生腹部并发症的胃癌患者的临床资料。其中62例患者存在术前伴发疾病为伴发组,其余76例患者术前无伴发疾病为非伴发组。分析伴发疾病情况,比较两组患者术后腹部并发症发病情况和短期生存状况。结果 62例患者中1例伴发3种疾病,9例伴发2种疾病,以轻度贫血、高血压、低蛋白血症和中度贫血为常见伴发疾病。伴发组患者的腹腔出血、吻合口出血、腹腔感染、吻合口瘘和切口感染发生率均高于非伴发组患者,差异具有统计学意义(P <0.05);两组患者的胰瘘、十二指肠残端瘘、肠梗阻、乳糜漏发生率比较差异无统计学意义(P>0.05)。伴发组和非伴发组患者术后3、6和12个月生存率比较差异无统计学意义(P>0.05)。结论胃癌微创手术患者腹部伴发疾病以贫血、高血压、低蛋白血症为主,患者术后腹部并发症发生率升高,但不会影响短期生存状况。Objective To investigate the impact of concomitant diseases on the incidence of abdominal complications in patients with primary gastric cancer undergoing laparoscopic surgery.Methods The clinical data of 138 gastric cancer patients who underwent laparoscopic-assisted radical gastrectomy after abdominal surgery were retrospectively analyzed from January 2015 to January 2017.Among them,62 patients had preoperative concomitant disease as the concomitant group,while the remaining 76 patients had no preoperative concomitant disease as the nonconcomitant group.The incidence of concomitant diseases was analyzed.The incidence of postoperative abdominal complications and short-term survival were compared between the two groups.Results 1 of the 62 patients had three diseases and 9 patients had two diseases.Mild anemia,hypertension,hypoalbuminemia and moderate anemia were common concomitant diseases.The incidence of intraperitoneal hemorrhage,anastomotic bleeding,abdominal infection,anastomotic fistula and incision infection in patients with concomitant disease were significantly higher than those in non-associated patients(P<0.05).The pancreatic fistula,there was no significant difference in the incidence of duodenal stump fistula,intestinal obstruction and chyle leakage(P>0.05).There were no significant differences in survival rates between 3 months,6 months and 12 months in patients with or without concomitant disease(P>0.05).Conclusion Patients with minimally invasive gastric cancer with abdominal diseases associated with anemia,hypertension,hypoproteinemia,the incidence of postoperative abdominal complications,but does not influence the short-term survival.

关 键 词：胃癌 微创手术 伴发疾病 腹部 并发症 

分 类 号：R735.2[医药卫生—肿瘤] R619[医药卫生—临床医学]