裸眼3D腹腔镜系统在腹腔镜胃肠恶性肿瘤根治术中应用价值的初步探索  

A primary investigation on application value of glasses⁃free three⁃dimensional laparoscopy system in laparoscopic radical resection of gastrointestinal malignant tumors

作　　者：蔡正昊 马君俊[1] 臧潞[1] 董峰[1] 冯波[1] 孙晶[1] 宗雅萍[1] 张鲁阳[1] 洪希周 陆爱国[1] 郑民华[1] Cai Zhenghao;Ma Junjun;Zang Lu;Dong Feng;Feng Bo;Sun Jing;Zong Yaping;Zhang Luyang;Hong Xizhou;Lu Aiguo;Zheng Minhua(Department of General Surgery,Department of Gastrointestinal Surgery,Ruijin Hospital,Shanghai Jiaotong University School of Medicine,Shanghai 200025,China)

机构地区：[1]上海交通大学医学院附属瑞金医院普通外科胃肠外科,200025

出　　处：《中华消化外科杂志》2020年第6期644-652,共9页Chinese Journal of Digestive Surgery

基　　金：国家重点研发计划(2017YFC0110801);上海市临床重点专科建设项目(shslczdzk00102)。

摘　　要：目的初步探讨裸眼3D腹腔镜系统在腹腔镜胃肠恶性肿瘤根治术中的应用价值。方法采用回顾性队列研究方法。收集2018年10月至2019年5月上海交通大学医学院附属瑞金医院收治的165例胃肠道恶性肿瘤患者的临床资料;男99例,女66例;中位年龄为63岁,年龄范围为28~86岁;胃癌68例,结直肠癌97例。68例胃癌患者中,16例选择裸眼3D腹腔镜系统行腹腔镜胃癌根治术,设为裸眼3D胃癌组;52例选择眼镜3D腹腔镜系统行腹腔镜胃癌根治术,设为眼镜3D胃癌组。97例结直肠癌患者中,19例选择裸眼3D腹腔镜系统行腹腔镜结直肠癌根治术,设为裸眼3D结直肠癌组;78例选择眼镜3D腹腔镜系统行腹腔镜结直肠癌根治术,设为眼镜3D结直肠癌组。观察指标:(1)胃癌患者手术情况。(2)胃癌患者术后恢复情况。(3)胃癌患者术后病理学检查情况。(4)结直肠癌患者手术情况。(5)结直肠癌患者术后恢复情况。(6)结直肠癌患者术后病理学检查情况。(7)随访情况。采用门诊或电话方式随访,了解患者并发症和生存情况,随访时间截至术后30 d。偏态分布的计量资料以M(P25,P75)或M(范围)表示,组间比较采用Mann⁃Whitney U检验。计数资料以绝对数或百分比表示,组间比较采用χ2检验或Fisher确切概率法。结果(1)胃癌患者手术情况:68例胃癌患者均顺利完成腹腔镜胃癌根治术,无术中并发症及中转开腹。裸眼3D胃癌组患者胃癌手术方式(远端胃切除术、全胃切除术),手术时间,术中出血量分别为11、5例,195 min(169 min,214 min),20 mL(10 mL,90 mL);眼镜3D胃癌组患者上述指标分别为31、21例,196 min(173 min,222 min),40 mL(20 mL,100 mL),两组患者上述指标比较,差异均无统计学意义(χ2=0.432,Z=-0.362,-1.065,P>0.05)。(2)胃癌患者术后恢复情况:裸眼3D胃癌组患者术后首次肛门排气时间,术后首次进食半流质食物时间、术后住院时间分别为2 d(2 d,3 d)、6 d(5 d,7 d)、10 Objective To primarily investigate the application value of glasses⁃free three⁃dimensional(3D)laparoscopy system in laparoscopic radical resection of gastrointestinal malignant tumors.Methods The retrospective cohort study was conducted.The clinical data of 165 patients with gastrointestinal malignant tumors who were admitted to the Ruijin Hospital of Shanghai Jiaotong University School of Medicine between October 2018 and May 2019 were collected.There were 99 males and 66 females,aged from 28 to 86 years,with a median age of 63 years.There were 68 of 165 patients with gastric cancer and 97 with colorectal cancer.Sixteen patients with gastric cancer who underwent laparoscopic radical gastrectomy using the glasses⁃free 3D laparoscopy system were divided into glasses⁃free 3D gastric cancer group,and 52 patients with gastric cancer who underwent laparoscopic radical gastrectomy using the polarized glasses 3D laparoscopy system were divided into polarized glasses 3D gastric cancer group.Nineteen patients with colorectal cancer who underwent laparoscopic radical colectomy or proctectomy using the glasses⁃free 3D laparoscopy system were divided into glasses⁃free 3D colorectal cancer group,and 78 patients with colorectal cancer who underwent laparoscopic radical colectomy or proctectomy using the polarized glasses 3D laparoscopy system were divided into polarized glasses 3D colorectal cancer group.Observation indicators:(1)operative situations of patients with gastric cancer;(2)postoperative recovery of patients with gastric cancer;(3)postoperative pathological examination results of patients with gastric cancer;(4)operative situations of patients with colorectal cancer;(5)postoperative recovery of patients with colorectal cancer;(6)postoperative pathological examination results of patients with colorectal cancer;(7)follow⁃up.Follow⁃up was conducted by outpatient examination or telephone interview to detect complications and survival of patients up to the postoperative 30th day.Measurement data with skew

关 键 词：胃肿瘤 结直肠肿瘤 裸眼3D 眼镜3D 腹腔镜检查 

分 类 号：R735[医药卫生—肿瘤]