手辅助腹腔镜与腹腔镜辅助胃癌根治术的疗效对比分析  

A comparative study of hand-assisted laparoscopic and laparoscopic-assisted radical gastrectomy

作　　者：侯越峰 邬建新 郭海鹰 Hou Yuefeng;Wu Jianxin;Guo Haiying(Department of general surgery,air force hospital of central theatercommand,Datong,Shanxi,037006,China)

机构地区：[1]大同市中部战区空军医院普通外科,山西大同037006

出　　处：《齐齐哈尔医学院学报》2022年第4期328-332,共5页Journal of Qiqihar Medical University

摘　　要：目的 探讨手辅助腹腔镜行胃癌根治术的临床应用价值。方法 选择2016年2月—2018年12月本院收治的胃癌患者60例作为研究对象,对符合纳入标准的患者以遵从患者意愿或频数匹配的方式入组,分别进入手辅助腹腔镜组(HALG组,30例)和腹腔镜辅助组(LAG组,30例)。收集其围手术期临床资料并进行比较分析。结果 HALG组的手术时间为(167.83±20.73)min,短于LAG组的(193.68±25.86) min,差异有统计学意义(P<0.01);切口长度为(7.55±0.17)cm,长于LAG组的(6.72±0.18)cm,差异有统计学意义(P<0.01);而HALG组清扫淋巴结数为(16.53±5.14)枚,比LAG组的(13.34±3.83)枚多,差异有统计学意义(P<0.05)。两组的术中出血量、肛门排气时间、术后住院时间和术后并发症相互比较无统计学差异(P>0.05)。行肥胖患者亚组分析HALG亚组术中出血量为(202.73±68.57) ml,少于LAG亚组的(316.67±108.97) ml,差异有统计学意义(P<0.05)。结论 手辅助腹腔镜行胃癌根治术具有手术时间短,且对肥胖患者优势更突出。Objective To explore the clinical value of hand-assisted laparoscopic radical gastrectomy. Methods 60 patients with the diagnosed as gastric cancer were enrolled in this prospective cohort study from February 2016 to December 2018. Patients who met the inclusion criteria were enrolled in accordance with patients’ wishes or frequency matching. The patients were assigned into two groups: the hand-assisted laparoscopic radical gastrectomy(HALG) group(n=30) and laparoscopic-assisted radical gastrectomy(LAG) group(n=30). Several perioperative clinical characteristics were collected and compared between the two groups. Results Operation time of HALG group(167.83±20.73 min) was shorter than that(193.68±25.86 min) of LAG group(P<0.01). The incision length of HALG group(7.55±0.17 cm) was longer than that(6.72±0.18 cm) of LAG group(P<0.01). Lymph node dissection number in HALG group(16.53±5.14) was more than that(13.34±3.83) of LAG group(P<0.05). There were no statistical significance in intraoperative blood loss, time to first flatus, postoperative hospitalization duration and postsurgical complications between the two groups(P>0.05). The intraoperative blood loss in the HALG subgroup was(202.73±68.57 mL), which was less than that(316.67±108.97 mL) in the LAG subgroup, and the difference was statistically significant(P<0.05).Conclusions Compared with LAG, HALG has shorter operation time and more advantages for obese patients.

关 键 词：手辅助 腹腔镜 胃癌 胃切除术 

分 类 号：R616.2[医药卫生—外科学]