3D腹腔镜根治性切除术在食管胃结合部腺癌治疗中的近期疗效研究  

Short-term efficacy of three-dimensional laparoscopic D2 radical gastrectomy in adenocarcinoma of the esophagogastric junction

作　　者：史振兴 曲辉[2] 汤小龙 孙国瑞[2] 何庆泗[2] 李荣梅 SHI Zhen-xing;QU Hui;TANG Xiao-long;SUN Guo-rui;HE Qing-si;LI Rong-mei(Medical College of Shandong University,Jinan 250012,China;Department of General Surgery,Qilu Hospital of Shandong University,Jinan 250012,China;Department of General Surgery,Leling People's Hospital,Leling 253600,China)

机构地区：[1]山东大学医学院,山东济南250012 [2]山东大学齐鲁医院普外科,山东济南250012 [3]乐陵市人民医院普外科,山东乐陵253000

出　　处：《中国现代普通外科进展》2019年第8期598-601,共4页Chinese Journal of Current Advances in General Surgery

摘　　要：目的:探讨3D腹腔镜根治性切除术在食管胃结合部腺癌中的优势和近期疗效。方法:回顾性分析山东大学齐鲁医院胃肠外科2018年1月-2019年4月39例3D腹腔镜根治性切除术治疗食管胃结合部腺癌患者的临床资料,并与同期37例行2D腹腔镜手术的患者的临床资料比较,比较2组患者在术前一般资料、手术时间、淋巴结清扫数量、术中出血等手术指标以及术后并发症、术后排气时间、术后住院时间等近期疗效指标方面的差异。结果:两组患者的一般资料差异无统计学意义(P>0.05);两组患者均顺利完成手术,无中转开腹。3D组手术时间明显短于2D组(201±25.9 min vs 257.6±38.6 min,P<0.05);与2D组比较,3D手术组术中出血更少(57.3±31.3 mL vs 86.2±58.6 mL,P<0.05);淋巴结清扫数目更多(32.6±10.1枚vs 24.1±8.2枚,P<0.05),而术后排气时间、术后住院时间、术后并发症发生率方面的差异无统计学意义(P均>0.05)。结论:与2D腹腔镜相比,3D腹腔镜下食管胃结合部腺癌的根治性切除在缩短手术时间,减少术中出血量及增加淋巴结清扫数目方面优势明显,且没有增加术后住院时间及并发症发生率,值得临床进一步推广。Objective:To evaluate the advantages and short-term efficacy of three-dimensional(3D)laparoscopic D2 radical gastrectomy in adenocarcinoma of the esophagogastric junction.Methods:Retrospective analysis was made to 39 cases who underwent 3D laparoscopic D2 radical gastrectomy and 37 cases who underwent conventional 2D laparoscopic D2 radical gastrectomy in our department from January 2018 to April 2019.All the surgeries were performed by the same team.The operation time,the number of lymph node dissection,intraoperative blood and other parameter were compared between the two group.Results:There was no significant difference between the two groups in baseline data(all P>0.05),the two groups of patients were successfully completed the operation without conversion.Compared with 2D group,3D group has more harvested lymph nodes(32.6±10.1)vs(24.1±8.2),less intraoperative blood(57.3±31.3)ml vs(86.2±58.6)ml and shorter operation time(201±25.9)min VS(257.6±38.6)min.Whereas no significant differences in time to first flatus,length of hospital stay,incidence of postoperative complications,were found between two group.Conclusion:three-dimensional laparoscopic D2 radical gastrectomy may be advantageous over two-dimensional laparoscopic D2 radical gastrectomy,which is worthy of further clinical promotion.

关 键 词：食管胃结合部腺癌 3D 腹腔镜 根治性切除 

分 类 号：R735[医药卫生—肿瘤]