腹腔镜胃癌根治术对老年进展期胃癌患者临床疗效和肿瘤微转移指标的影响  

Effect of gastric cancer laparoscopic radical resection on the treatment of advanced gastric cancer in elderly patients and the tumor micrometastasis

作　　者：李洪涛 张军[1] 熊国栋 刘杰 王仁军 LI Hong-tao;ZHANG Jun;XIONG Guo-dong;LIU Jie;WANG Ren-jun(Department of General Surgery,Dazhou Central Hospital,635000 Dazhou,Sichuan,China)

机构地区：[1]达州市中心医院普通外科,四川达州635000

出　　处：《临床消化病杂志》2020年第3期187-190,共4页Chinese Journal of Clinical Gastroenterology

摘　　要：[目的]比较腹腔镜胃癌根治术与传统开腹术在老年进展期胃癌患者中应用对临床疗效和肿瘤微转移指标水平的影响.[方法]选取因进展期胃癌需手术治疗的老年患者74例,分为观察组和对照组,每组37例.观察组采用腹腔镜胃癌根治术治疗,对照组采用传统开腹术治疗,比较2组治疗后临床指标、3年生存率和肿瘤微转移指标水平.[结果]观察组手术时间为(265.30±29.35)min多于对照组的(207.83±30.27)min,差异具有统计学意义(P<0.05);观察组术中出血量、切口长度分别为(175.62±24.32)ml、(5.89±1.26)cm,少于对照组的(320.54±32.65)ml、(16.30±3.51)cm,差异具有统计学意义(P<0.05);观察组肛门排气时间、进食时间、下床活动时间和住院时间分别为(3.88±0.79)d、(4.23±1.21)d、(4.06±1.05)d和(10.29±2.65)d,对照组分别为(6.30±1.21)d、(5.40±1.35)d、(6.37±1.52)d和(16.95±3.27)d,观察组均明显少于对照组,差异具有统计学意义(P<0.05),观察组、对照组的3年总生存率分别为64.86%、40.54%,2组比较差异具有统计学意义(P<0.05).同时,手术治疗后,观察组多巴胺脱羧酶(DDC)和癌胚抗原(CEA)水平较对照组显著降低,差异有统计学意义(P<0.05).[结论]腹腔镜胃癌根治术治疗老年进展期胃癌临床效果较好,生存率提高,手术后肿瘤微转移的风险更低,具有临床推广价值.[Objective]To compare and analyze the clinical efficacy of laparoscopic radical gastrectomy and traditional laparotomy on the advanced gastric cancer in elderly patients and tumor micrometastasis.[Methods]From May 2013 to August 2015,a retrospective selection of 74 elderly advanced gastric cancer patients treated with surgery was recruited.The patients were divided into 2 groups and set as observation group and control group,37 cases in each group.The observation group was treated with laparoscopic radical gastrectomy,and the control group was treated with traditional laparotomy.The clinical indicators,3year survival rate and tumor micrometastasis indicators after treatment were compared.[Results]The operation time of the observation group was 265.30±29.35 minutes,which was significantly longer than that of the control group(207.83±30.27 minutes)(P<0.05).The blood loss and incision length in the observation group were 175.62±24.32 ml and 5.89±1.26 cm respectively,which were significantly lower than those in the control group([320.54±32.65]ml and[16.30±3.51]cm),P<0.05.The time of anal exhaust,eating,getting out of bed activity and hospitalization in the observation group were(3.88±0.79)d,(4.23±1.21)d,(4.06±1.05)d,and(10.29±2.65)d,respectively,and those in the control group were(6.30±1.21)d,(5.40±1.35)d,(6.37±1.52)d,and(16.95±3.27)d.The difference was statistically significant(P<0.05).The 3-year overall survival rates of the observation group and the control group were 64.86%and 40.54%respectively,the difference was statistically significant(P<<0.05).At the same time,the levels of dopamine decarboxylase(DDC)and carcinoembryonic antigen(CEA)in the observation group were significantly lower than those in the control group(P<0.05).[Conclusion]Laparoscopic radical gas-trectomy for advanced gastric cancer has good clinical effect.It can improve the survival rate and decrease the risk of tumor micrometastasis after surgery.It's recommended clinical promotion applications.

关 键 词：胃癌 腹腔镜胃癌根治术 临床疗效 肿瘤微转移 

分 类 号：R735.2[医药卫生—肿瘤]