3D腹腔镜手术治疗进展期胃癌围术期疗效分析  

Perioperative efficacy of 3D laparoscopic gastrectomy for advanced gastric cancer

作　　者：严东羿[1] 张顺 袁彪[1] 杨飖[1] 曹东亮[1] 蒋小华[1] YAN Dongyi;ZHANG Shun;YUAN Biao;YANG Yao;CAO Dongliang;JIANG Xiaohua(Department of Gastrointestinal Surgery,Shanghai East Hospital,Tongji University,Shanghai,200123,China)

机构地区：[1]同济大学附属东方医院胃肠肛肠外科

出　　处：《外科理论与实践》2019年第6期535-539,共5页Journal of Surgery Concepts & Practice

基　　金：上海市浦东新区卫生系统优秀学科带头人项目(PWRD2014-04);2017上海市浦东新区卫生系统特色专病项目(胃癌)(PWZzb2017-5)

摘　　要：目的:探讨3D腹腔镜胃癌D2根治术治疗进展期胃癌的围术期疗效。方法:回顾性分析我科2016年1月至2018年12月,181例进展期胃癌行胃癌D2根治术的临床资料,其中3D腹腔镜手术87例(3D组),开腹手术94例(开腹组)。比较两组围术期指标。结果:3D组无中转开腹。所有病例均为R0切除。围术期无死亡病例。两组手术时间、术后住院时间、术后并发症发生率差异均无统计学意义(P>0.05)。3D组术中出血量(155.06±144.95) mL少于开腹组(214.47±220.58) mL,两组差异有统计学意义(P=0.035)。3D组术后首次排气时间早于开腹组,两组差异有统计学意义(P=0.004)。术后进流质和半流质的开始时间,3D组亦早于开腹组,两者差异有统计学意义(P<0.05)。3D组淋巴结清扫数与开腹组相比,差异无统计学意义(P>0.05)。结论:3D腹腔镜胃癌D2根治术治疗进展期胃癌是一种安全可行、创伤小、恢复快的手术方式。Objective To investigate the perioperative efficacy of 3D laparoscopic D2 radical gastrectomy in the treatment of advanced gastric cancer. Methods We analyze retrospectively 181 cases with advanced gastric cancer undergoing D2 radical gastrectomy in our department from January 2016 to December 2018 including 87 cases of 3D laparoscopic gastrectomy(3D group) and 94 cases of open gastrectomy(open group). The perioperative data were compared between two groups. Results There was no case in 3D group conversion to open. R0 dissection was gotten all in this study. No perioperative mortality was found. There was no significant difference in operative time, postoperative hospital stay and postoperative complications between two groups(P>0.05). The intraoperative blood loss in 3D group(155.06±144.95) mL was significantly less than that in open group(214.47±220.58) mL(P=0.035). Postoperative pass gas time, the time in taking liquid food and semi-liquid food were all earlier in 3D group than those in open group significantly(P=0.004, P<0.05). No significant difference was present in lymph node dissection between two groups(P>0.05). Conclusions 3D laparoscopic D2 radical gastrectomy could be a safe and feasible surgical type for advanced gastric cancer with quicker recovery and minimal injury.

关 键 词：进展期胃癌 3D腹腔镜胃癌D2根治术 围术期疗效 

分 类 号：R735.2[医药卫生—肿瘤]