胃癌伴幽门梗阻患者的腹腔镜手术价值探讨  

Value of laparoscopic operation in treating gastric cancer patients with pyloric obstruction

作　　者：张洪志[1] 任远[1] 张旭 姚国忠[1] ZHANG Hongzhi;REN Yuan;ZHANG Xu;YAO Guozhong(Department of Gastrointestinal Surgery,Liyang City People′s Hospital of Jiangsu Province,Liyang,Jiangsu,213300)

机构地区：[1]江苏省溧阳市人民医院胃肠外科,溧阳江苏213300

出　　处：《实用临床医药杂志》2020年第21期9-11,共3页Journal of Clinical Medicine in Practice

摘　　要：目的探讨腹腔镜手术治疗胃癌伴幽门梗阻患者的应用价值。方法分析76例胃癌合并幽门梗阻患者的临床资料,其中行腹腔镜探查术中转进腹行根治术或姑息性切除术的患者27例,仅行胃肠旁路手术的患者39例,行腹腔镜辅助根治性胃切除术的患者10例。将39例仅行胃肠旁路手术的患者根据手术路径不同分为全腹腔镜组(n=21)和中转进腹组(n=18)。记录2组手术时间、术中出血量、手术切口长度、胃肠功能恢复时间、术后首次下床活动时间及进食时间、住院时间以及术后6 h的视觉模拟评分法(VAS)评分和并发症发生率。结果全腹腔镜组围术期指标优于中转进腹组,肺部感染发生率低于中转进腹组,差异均有统计学意义(P<0.01)。结论腹腔镜手术治疗对于进展期胃癌伴幽门梗阻患者有较多优势。Objective To investigate application value of laparoscopic operation in treating gastric cancer patients with pyloric obstruction.Methods The data of 76 gastric cancer patients with pyloric obstruction was retrospectively analyzed,including 27 cases receiving conversion to open radical gastrectomy or palliative gastrectomy during laparoscopic approach,39 patients only receiving gastrointestinal bypass surgery,and 10 cases receiving laparoscopic assisted radical gastrectomy.A total of 39 patients only receiving gastrointestinal bypass surgery were divided into total laparoscopic group(n=21)and laparotomy conversion group(n=18)according to different surgical approaches.Operative time,intraoperative blood loss,length of incision,recovery time of gastrointestinal function,time to first postoperative ambulation and food intake time,length of hospital stay,Visual Analogue Scale(VAS)score at 6 h after surgery and incidence of complications were recorded in the two groups.Results The perioperative indexes of the total laparoscopic group were significantly better than those of laparotomy conversion group,and the incidence of pulmonary infection was significantly lower than that of the laparotomy conversion group(P<0.01).Conclusion Laparoscopic operation has obvious advantages for progression phase gastric cancer patients with pyloric obstruction.

关 键 词：腹腔镜手术 胃肿瘤 幽门梗阻 中转进腹手术 

分 类 号：R857.12[医药卫生—航空、航天与航海医学]