腹腔镜胃楔形切除术与经脐单孔腔镜胃楔形切除术的临床疗效对比分析  

Comparative analysis of the clinical effect of laparoscopic gastric wedge resection and transumbilical laparoendoscopic single site gastric wedge resection

作　　者：程之逸[1] 赵小军[1] 尤小兰[1] 黄传江[1] 刘贵远[1] 毛旭南 Cheng Zhiyi;Zhao Xiaojun;You Xiaolan;Huang Chuanjiang;Liu Guiyuan;Mao Xunan(General surgery Department of Taizhou people’s,Hospital 225300)

机构地区：[1]泰州市人民医院普外科,江苏225300

出　　处：《中华普外科手术学杂志（电子版）》2020年第5期495-498,共4页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

基　　金：江苏省卫生和计划委员会医学应用项目(面上)(JS201500671)。

摘　　要：目的对比腹腔镜胃楔形切除术与经脐单孔腔镜胃楔形切除术的临床疗效。方法回顾性选取2016年1月至2019年4月确诊为胃间质瘤且行腹腔镜胃楔形切除术的63例患者进行研究。根据手术方式不同36例行腹腔镜胃楔形切除术患者列为五孔组,将27行经脐单孔腔镜胃楔形切除术患者列为单孔组。采用SPSS 25.0统计学软件进行数据分析,围术期指标、营养指标、生活质量评分等计量资料采用(±s)表示,组间比较采用独立样本t检验;术后并发症等计数资料组间比较卡方χ2检验;等级计数资料采用秩和检验。P<0.05差异有统计学意义。结果两组均顺利完成手术,无死亡、中转开腹或转为开腹手术病例,术后病理证实均为R0切除。单孔组手术时间及术中出血量少于五孔组(P<0.05);术后排气时间、住院时间、术后并发症、术后营养指标等,两组差异均无统计学意义。术后3个月单孔组患者生理职(功)能、躯体疼痛优于五孔组(P<0.05),其他生活质量评分差异均无统计学意义。结论经脐单孔腹腔镜胃楔形切除术疗效较常规腹腔镜胃楔形切除术近似,且具有术时短、出血少、更微创等优势,可在临床中逐步推广应用。Objective To compare and explore the clinical efficacy of laparoscopic gastric wedge resection and transumbilical laparoendoscopic single site gastric wedge resection gastric wedge resection.Methods A retrospective study was conducted on 63 patients who were diagnosed with gastric stromal tumor and underwent gastric wedge resection in our hospital from January 2016 to April 2019.According to the different surgical methods,36 cases of laparoscopic gastric wedge resection were classified as the five-hole group,and 27 cases of transumbilical laparoendoscopic single site gastric wedge resection were classified as the single-hole group.SPSS 25.0 statistical software was used for data analysis.Perioperative indicators,nutritional indicators,quality of life scores and other measurement data were expressed as(±s),and inter-group comparisons were performed by independent sample t test.Chi-square was used to compare postoperative complications and other counting data.Rank sum test was used for rank count data.The difference of P<0.05 was statistically significant.Results The surgery was successfully completed in the two groups,No death,conversion to open surgery cases were found.R0 resection was confirmed by postoperative pathology in all cases.The operation time and intraoperative blood loss in the single-hole group were less than those in the five-hole group(P<0.05).There were no significant differences in postoperative exhaust time,hospital stay,postoperative complications and postoperative nutritional indexes between the two groups.Three months after the operation,the single-hole group had better physiological function(work)and physical pain than the five-hole group(P<0.05).There was no significant difference in other QOL scores.Conclusion Compared with conventional laparoscopic gastrectomy,laparoendoscopic single site gastric wedge resection has the advantages of short operation time,less bleeding and more minimally invasive,which can be gradually popularized and applied in clinical practice.

关 键 词：胃肠道间质肿瘤 腹腔镜 胃切除术 疗效比较研究 经脐单孔 

分 类 号：R735[医药卫生—肿瘤]