腹腔镜辅助下全胃切除术与近端胃切除术对进展期胃癌患者围术期指标及预后的影响  

Effect of laparoscope assisted total gastrectomy and proximal gastrectomy on perioperative indexes and prognosis in patients with advanced gastric cancer

作　　者：季超[1] 黄河[1] 王梦桥[1] JI Chao;HUANG He;WANG Meng-qiao(Department of Gastrointestinal Surgery,Chengdu Fifth People's Hospital,Chengdu 611130,China)

机构地区：[1]成都市第五人民医院胃肠外科,成都611130

出　　处：《中国医学前沿杂志（电子版）》2019年第4期89-92,共4页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

摘　　要：目的探讨腹腔镜辅助下全胃切除术与近端胃切除术对进展期胃癌患者围术期指标及预后的影响。方法回顾性分析2015年3月至2016年3月本院收治的142例进展期胃癌患者的临床资料,依据治疗方法不同将其分为对照组(60例)和观察组(82例),对照组患者采用腹腔镜辅助下近端胃切除术,观察组患者采用腹腔镜辅助下全胃切除术,比较两组患者手术时间、术后肛门排气时间、术中出血量、住院天数、实验室指标(血红蛋白、总蛋白、白蛋白)、术后并发症及预后情况。结果观察组患者手术时间、术后肛门排气时间均较对照组明显延长(P_均<0.05),两组患者术中出血量、住院天数比较均无明显差异(P_均> 0.05);与治疗前比较,治疗后两组患者血红蛋白、总蛋白、白蛋白均明显升高(P_均<0.05),但观察组患者上述指标水平均显著低于对照组(P_均<0.05);观察组患者术后并发症发生率明显低于对照组(P <0.05);随访2年,两组患者生存率比较无显著差异(P> 0.05),观察组患者复发率显著低于对照组(P <0.05),术后随访生活质量显著优于对照组(P <0.05)。结论腹腔镜辅助下全胃切除术治疗进展期胃癌在改善预后方面较腹腔镜辅助下近端胃切除术更具优势,但前者的手术时间和术后肛门排气时间较长,且需注意改善患者术后营养状况。Objective To investigate the influence of laparoscope assisted total gastrectomy and proximal gastrectomy on perioperative indexes and prognosis in patients with advanced gastric cancer.Method Retrospective analyzed the clinical data of 142 patients with advanced gastric cancer admitted to our hospital from March 2015 to March 2016.According to the different treatment methods,they were divided into control group(n=60)and observation group(n=82).Control group patients were treated by proximal gastrectomy with laparoscopic assistance,and observation group patients were treated by total gastrectomy with laparoscopic assistance.The operation time,postoperative anal exhaust time,intraoperative blood loss,hospital stay,laboratory parameters(hemoglobin,total protein,albumin),postoperative complication and prognosis were compared between the two groups.Result The operation time and postoperative anal exhaust time of observation group were significantly longer than those of control group(Pall<0.05),but there were no significant differences in intraoperative blood loss and hospital stay between the two groups(Pall>0.05).Compared with before treatment,hemoglobin,total protein and albumin were significantly increased in the two groups after treatment(Pall<0.05),but the above indicators levels in observation group were significant lower that in control group(Pall<0.05).The incidence of postoperative complications in observation group was lower than that in control group(P<0.05).There was no significant difference in 2-year follow-up survival rate between two groups(P>0.05),but the recurrence rate in observation group was lower than that in control group(P<0.05),the quality of life was significantly better than that in control group(P<0.05).Conclusion Laparoscope assisted total gastrectomy has more advantages over proximal gastrectomy for advanced gastric cancer in terms of improving prognosis.However,the operation time and postoperative anal exhaust time of the former are longer,and the patients postoperative nutritional stat

关 键 词：进展期胃癌 腹腔镜 全胃切除术 近端胃切除术 围术期 并发症 

分 类 号：R735.2[医药卫生—肿瘤]