弯型梅氏解剖剪联合血管控制技术在根治性全胃切除术中应用价值  

Application of bending Mayo dissecting scissors combined with vessel controlling technique in radical total gastrectomy

作　　者：程勇 韩广森 顾焱晖 李剑 张世甲 任莹坤 华科雷 王振雷 霍明科 润增慈 翟科伟 CHENG Yong;HAN Guang-sen;GU Yan-hui;LI Jian;ZHANG Shi-jia;REN Ying-kun;HUA Ke-lei;WANG Zhen-lei;HUO Ming-ke;RUN Zeng-ci;ZHAI Ke-wei(Department of General Surgery,Zhengzhou University Cancer Hospital,Henan Cancer Hospital,Zhengzhou,Henan 450008,China)

机构地区：[1]郑州大学附属肿瘤医院河南省肿瘤医院普外科,河南郑州450008

出　　处：《中华实用诊断与治疗杂志》2022年第10期1034-1037,共4页Journal of Chinese Practical Diagnosis and Therapy

基　　金：河南省科技攻关计划项目(162102310041)。

摘　　要：目的探讨根治性全胃切除术中采用弯型梅氏解剖剪联合血管控制技术的效果及安全性。方法186例行根治性全胃切除术患者,其中术中采用弯型梅氏解剖剪联合血管控制技术患者89例为观察组,采用传统手术操作方法者97例为对照组,比较2组肿瘤位置、分化程度、临床分期、新辅助化疗情况;比较2组淋巴结清扫个数、阳性淋巴结个数、术中出血量、手术时间、术后住院时间及术后并发症发生情况。结果观察组肿瘤位置、分化程度、临床分期、新辅助化疗情况与对照组比较差异均无统计学意义(P>0.05)。观察组术中出血量[(198.2±62.8)mL]少于对照组[(247.9±113.8)mL](t=3.729,P<0.001),手术时间[(120.2±31.1)min]短于对照组[(147.8±28.7)min](t=6.283,P<0.001),淋巴结清扫个数[(19.8±5.4)个]、阳性淋巴结个数[(3.8±2.2)个]、术后住院时间[(11.8±3.5)d]及术后并发症发生率(6.7%)与对照组[(19.0±5.6)个、(3.2±2.3)个、(12.9±4.7)d、8.2%]比较差异均无统计学意义(P>0.05)。结论根治性全胃切除术中采用弯型梅式解剖剪联合血管控制技术可充分清扫淋巴结,减少术中出血量,缩短手术时间。Objective To evaluate the effect and safety of bending Mayo dissecting scissors combined with vessel controlling technique in radical total gastrectomy.Methods In 186patients undergoing radical total gastrectomy,89 patients used bending Mayo dissecting scissors combined with vessel controlling skill(observation group)and 97patients used traditional method(control group).The tumor location,differentiation degree,clinical stage,neoadjuvant chemotherapy,number of lymph nodes,number of positive lymph nodes,intraoperative blood loss,operation lasting time,length of postoperative hospital stay and postoperative complications were compared between two groups.Results There were no significant differences in the tumor location,differentiation degree,clinical stage and neoadjuvant chemotherapy between two groups(P>0.05).The blood loss was less and the operation lasting time was shorter in observation group[(198.2±62.8)mL,(120.2±31.1)min]than that in control group[(247.9±113.8)mL,(147.8±28.7)min](t=3.729,P<0.001;t=6.283,P<0.001).There were no significant differences in the number of lymph nodes(19.8±5.4 vs.19.0±5.6),number of positive lymph nodes(3.8±2.2 vs.3.2±2.3),length of postoperative hospital stay[(11.8±3.5)d vs.(12.9±4.7)d]and incidence of postoperative complications(6.7%vs.8.2%)between two groups(P>0.05).Conclusion Bending Mayo dissecting scissors combined with vessel controlling technique in radical total gastrectomy can thoroughly clear lymph nodes,reduce the intraoperative blood loss,and shorten the operation time.

关 键 词：胃癌 根治性全胃切除术 梅氏解剖剪 血管控制技术 

分 类 号：R735.2[医药卫生—肿瘤]