腹腔镜辅助下根治性全胃切除术与根治性近端胃切除术在贲门癌中应用的疗效对比  

Between Laparoscopic-assisted Radical Total Gastrectomy and Radical Proximal Gastrectomy in the Treatment of Cardia Cancer

作　　者：关军 许建新 许志扬 GUAN Jun;XU Jianxin;XU Zhiyang(Department of General Surgery,Putian First Hospital,Teaching Hospital of Fujian Medical University,Putian,Fujian Province,351100 China)

机构地区：[1]福建医科大学教学医院莆田市第一医院普外科,福建莆田351100

出　　处：《中外医疗》2021年第30期60-63,共4页China & Foreign Medical Treatment

摘　　要：目的探讨对贲门癌患者采用腹腔镜辅助下根治性全胃切除术以及根治性近端胃切除术治疗后获得的临床效果。方法方便选取该院2018年1月—2020年12月收治的160例贲门癌患者,随机分为近端胃切除术组和全胃切除术组,各80例。比较两组患者术后近期疗效、术中情况、术后近期生活质量评分以及手术并发症发生率。结果全胃切除术组引流管拔除时间、首次排气时间、进流食时间、术后住院时间、切口长度、术中出血、手术时间同近端胃切除术组比较,差异无统计学意义(P>0.05);全胃切除术组角色功能、躯体功能、情绪功能、认知功能、社会功能、整体健康状况评分均高于近端胃切除术组,差异有统计学意义(P<0.05);全胃切除术组吻合口出血、吻合口瘘、肠梗阻以及吻合口狭窄发生率同近端胃切除术组比较,差异无统计学意义(P>0.05);全胃切除术组手术并发症总发生率10.00%低于近端胃切除术组20.00%,差异有统计学意义(χ^(2)=3.137,P<0.05)。结论腹腔镜辅助下根治性全胃切除术治疗方式有效应用,同腹腔镜辅助下根治性近端胃切除术治疗比较,可将患者术后近期生活质量显著提高,将反流性食管炎发生率有效降低,促进贲门癌患者整体治疗水平、预后水平显著提高。Objective To explore the clinical effects of laparoscopic-assisted radical total gastrectomy and radical proximal gastrectomy in patients with cardiac cancer.Methods Conveniently selected 160 patients with cardia cancer admitted from January 2018 to December 2020 in the hospital for surgical treatment research.They were randomly divided into proximal gastrectomy group and total gastrectomy group,with 80 cases in each.The short-term curative effect,intraoperative conditions,short-term postoperative quality of life scores and the incidence of surgical complications were compared between the two groups.Results There were no significant differences in drainage tube removal time,first exhaust time,intake time,postoperative hospital stay,incision length,intraoperative bleeding and operation time between total gastrectomy group and proximal gastrectomy group(P>0.05).The scores of role function,physical function,emotional function,cognitive function,social function and overall health status in total gastrectomy group were higher than those in proximal gastrectomy group,and the differences were statistically significant(P<0.05).The incidence of anastomotic bleeding,anastomotic fistula,intestinal obstruction and anastomotic stenosis in total gastrectomy group was not significantly different from that in proximal gastrectomy group(P>0.05).The incidence of surgical complication in total gastrectomy group was(0.00%),lower than that in proximal gastrectomy group(20.00%),the difference was statistically significant(χ^(2)=3.137,P<0.05).Conclusion The effective application of laparoscopic-assisted radical total gastrectomy,compared with laparoscopic-assisted radical proximal gastrectomy,can significantly improve the postoperative quality of life of patients,effectively reduce the incidence of reflux esophagitis,and promote the overall treatment level and prognosis of patients with cardiac cancer.

关 键 词：贲门癌 腹腔镜辅助下根治性全胃切除术 根治性近端胃切除术 近期疗效 并发症 

分 类 号：R735[医药卫生—肿瘤]