单孔加一腹腔镜远端胃癌根治术治疗BorrmannⅢ、Ⅳ型胃癌的安全性与可行性研究  

Safety and feasibility of single incision plus one port laparoscopic distal radical gastrectomy for BorrmannⅢ-Ⅳgastric cancer

作　　者：刘玉美[1] 钟峰[1] 孙小可[2] Liu Yumei;Zhong Feng;Sun Xiaoke(Department of General Surgery,Langfang Municipal People’s Hospital,Langfang 065000,China;Operating Room,Langfang Municipal People’s Hospital,Langfang 065000,China)

机构地区：[1]廊坊市人民医院普外一科,065000 [2]廊坊市人民医院手术室,065000

出　　处：《中华普通外科学文献（电子版）》2022年第3期210-214,共5页Chinese Archives of General Surgery(Electronic Edition)

基　　金：河北省医学科学研究课题资助项目(20200183)。

摘　　要：目的探究BorrmannⅢ、Ⅳ型胃癌施行单孔加一腹腔镜(SILS+1)远端胃癌根治术治疗的近期效果。方法前瞻性选取2018年1月至2020年12月廊坊市人民医院收治的81例行腹腔镜远端胃癌根治术的BorrmannⅢ型和Ⅳ型患者。按照随机数字表法分为SILS+1组(41例)和传统5孔腹腔镜组(5孔组,40例),所有患者均予以围手术期加速康复外科理念支持。比较两组围手术期相关指标、术后并发症发生率、营养状况指标和炎性应激指标水平变化。结果SILS+1组切口长度、肠道功能恢复时间、术后住院时间均优于5孔组(P<0.05),两组手术时间、术中出血量及淋巴结清扫数目、术后并发症总发生率比较,差异均无统计学意义。术后1、5 d时,SILS+1组血清白蛋白、前白蛋白水平及C反应蛋白、白介素6水平变化恢复情况优于5孔组(P<0.05)。结论SILS+1腹腔镜远端胃癌根治术治疗BorrmannⅢ、Ⅳ型胃癌能有效改善患者术后营养状况,降低炎性反应,促进患者术后恢复,具有良好的近期疗效。Objective To investigate the short-term effect of distal radical gastrectomy for Borrmann typeⅢ-Ⅳgastric cancer using single incision plus one port laparoscopic surgery(SILS+1).Methods Eighty-one patients with laparoscopic distal radical gastrectomy admitted to Langfang Municipal People’s Hospital from January 2018 to December 2020 were prospectively selected,all of whom were Borrmann typeⅢ-Ⅳ.According to digital random method,they were divided into SILS+1 group(41 cases)and traditional 5-hole laparoscopic group(5-hole group,40 cases).All patients received perioperative accelerated rehabilitation surgical concept support.The changes of perioperative related indexes,postoperative complication rate,nutritional status indexes and inflammatory stress indexes were compared between the two groups.Results The incision length,bowel sound recovery time and postoperative hospitalization time of SILS+1 group were better than those of the 5-hole group(all P<0.05).There were no significant differences in operative time,intraoperative blood loss,the number of dissected lymph nodes,and the total incidence of postoperative complications between the two groups.On 1 and 5 days after operation,the recovery of serum albumin,prealbumin,C-reactive protein and interleukin-6 levels in SILS+1 group were better than those in 5-hole group(P<0.05).Conclusion The application of SILS+1 laparoscopic radical distal gastrectomy for Borrmann typeⅢ-Ⅳgastric cancer can effectively improve the postoperative nutritional status,reduce inflammatory response,and promote postoperative recovery,with good short-term efficacy.

关 键 词：加速康复外科 单孔加一 腹腔镜 远端胃癌根治术 BorrmannⅢ、Ⅳ型 

分 类 号：R735.2[医药卫生—肿瘤]