单孔加一腹腔镜远端胃癌根治术应用于老年患者的初步探索  

Preliminary exploration of single-incision plus one port laparoscopic radical gastrectomy for distal gastric cancer in elderly patients

作　　者：滕文浩[1] 臧卫东[1] 刘文居[1] 姜键平 陈梅梅 TENG Wen-hao;ZANG Wei-dong;LIU Wen-ju(Department of Gastrointestinal Oncology Surgery,Fujian Cancer Hospital,Fuzhou 350014,China)

机构地区：[1]福建医科大学附属肿瘤医院,福建省肿瘤医院胃肠肿瘤外科,福建福州350014

出　　处：《腹腔镜外科杂志》2022年第1期34-39,共6页Journal of Laparoscopic Surgery

基　　金：福建省自然科学基金面上项目(2019J01200);福建省卫生健康青年科研课题(2019-2-4);福建医科大学启航基金项目(2018QH1223);白求恩·爱惜康卓越外科基金项目(HZB-20181119-46);福建省肿瘤医院基金项目(2021YN06)。

摘　　要：目的:探讨单孔加一腹腔镜远端胃癌根治术在老年患者中应用的近期疗效。方法:回顾分析2017年12月至2021年10月收治的49例老年胃癌患者的临床资料,根据手术方式分为单孔加一组(n=21)与常规五孔法腹腔镜手术组(n=28,常规组),比较两组围手术期指标及术后30 d内并发症情况。结果:两组均无围手术期死亡病例。两组出血量、肿瘤最大径、清扫淋巴结数量、重建方式、首次排气时间、首次进食时间、首次排便时间、术后住院时间、术后并发症差异均无统计学意义(P>0.05),单孔加一组手术时间、总切口长度更短,首次下床活动时间更早,术后前3 d疼痛更轻,两组差异有统计学意义(P<0.05)。结论:单孔加一腹腔镜胃癌根治术治疗老年远端胃癌是安全、可行的,且具有手术时间短、疼痛轻等优势。Objective:To investigate the short-term outcomes of single-incision plus one port laparoscopic radical gastrectomy for distal gastric cancer in elderly patients.Methods:A retrospective analysis was conducted to collect data of 49 elderly patients with gastric cancer from Dec.2017 to Oct.2021.According to different surgical methods,the patients were divided into the single-incision plus one port group(21 cases),and the conventional five-port surgery group(28 cases).The perioperative indicators and complications within 30 d after surgery were compared between the two groups.Results:There was no perioperative death in both groups.There was no statistically significant difference in blood loss,maximum diameter of tumor,number of harvested lymph nodes,reconstruction methods,time to the first flatus,time to first oral intake,time to the first defecation,postoperative hospital stay and postoperative complications,(P>0.05).While it showed shorter operation time and the total length of incision,earlier ambulation,and lighter postoperative pain three days after surgery in the single-incision plus one port group,and the difference between the two groups was statistically significant(P<0.05).Conclusions:It is safe and feasible to perform single-incision plus one port laparoscopic radical gastrectomy for distal gastric cancer in elderly patients,and there are several advantages such as shorter operation time and lighter postoperative pain.

关 键 词：胃肿瘤 胃癌根治术 腹腔镜检查 单孔加一 老年人 

分 类 号：R735.2[医药卫生—肿瘤]