开腹与腹腔镜脾门淋巴结清扫对进展期胃癌的近期疗效观察及生存分析  

Short-term curative effect and survival analysis of laparotomy and laparoscopic splenichilar lymph node dissection for advanced gastric cancer

作　　者：朱海丰[1] 严栋梁[2] ZHU Haifeng;YAN Dongliang(Department of General Surgery,Nantong Hospital of Traditional Chinese Medicine,Nantong 226001,China;Department of General Surgery,Nantong First People's Hospital,Nantong 226001,China)

机构地区：[1]南通市中医院普外科,江苏南通226001 [2]南通市第一人民医院普外科,江苏南通226001

出　　处：《中国肿瘤外科杂志》2022年第6期563-566,共4页Chinese Journal of Surgical Oncology

摘　　要：目的探讨开腹与腹腔镜脾门淋巴结清扫对进展期胃癌的近期疗效及生存情况。方法选择2017年1月至2019年6月南通市中医院收治的86例拟行根治性全胃切除术的进展期胃癌为研究对象,对照组采用开腹脾门淋巴结清扫,研究组采用腹腔镜脾门淋巴结清扫。比较两组术中、术后情况、术后7 d并发症发生情况及无进展生存时间。结果两组总手术时间、肿瘤大小、No.10淋巴结清扫时间、No.10淋巴结清扫数目、淋巴结总清扫数目比较差异无统计学意义(P>0.05),研究组总出血量、清扫No.10淋巴结出血量低于对照组(P<0.05);两组引流管拔出时间、住院费用比较差异无统计学意义(P>0.05),研究组住院时间、术后首次排便时间、胃管拔出时间、术后首次排气时间均短于对照组(P<0.05);两组术后7 d内并发症总发生率比较差异无统计学意义(P>0.05);随访3年,对照组失访1例,研究组失访2例,随访率为96.51%,研究组与对照组无进展生存时间分别为22.35个月(95%CI:12.39~28.41)、21.73个月(95%CI:9.25~24.52),两组无进展生存曲线比较,差异无统计学意义(P>0.05)。结论在进展期胃癌根治性全胃切除术中,腹腔镜脾门淋巴结清扫近期效果良好,安全可行,且预后良好。Objective To investigate the short-term efficacy and survival of laparotomy and laparoscopic splenic hilar lymph node dissection for advanced gastric cancer.Methods Eighty-six patients with advanced gastric cancer who underwent radical total gastrectomy admitted to the Nantong Traditional Chinese Medicine Hospital from January 2017 to June 2019 were selected and divided into control group(laparotomy,n=43)and study group(laparoscope,n=43).The intraoperative and postoperative conditions,the occurrence of complications and progression-free survival time on the 7th day after operation were compared between the two groups.Results There was no significant difference on the total operation time,tumor size,No.10 lymph node dissection time,and the numbers of No.10 and total lymph node dissection between the two groups(P>0.05).The total bleeding volume of the study group and the bleeding volume of No.10 lymph node dissection were lower than those of the control group(P<0.05).There was no statistically significant difference between the two groups in the drainage tube removal time and hospitalization expenses(P>0.05).The length of hospital stay,postoperative first defecation time,gastric tube removal time and first postoperative exhaust time in study group were shorter than those of the control group(P<0.05).There was no significant difference in the total incidence of complications within 7 days after the operation between the two groups(P>0.05).After 3 years of follow-up,1 case was lost in the control group and 2 cases in the study group,with a follow-up rate of 96.51%.The progression free survival time in the study group and the control group were 22.35 months(95%CI:12.39-28.41)and 21.73 months(95%CI:9.25-24.52),respectively.There was no difference in the progression free survival curve between the two groups(P>0.05).Conclusions Laparoscopic splenic hilar lymph node dissection for advanced gastric cancer has good short-term results with good safety and feasibility.

关 键 词：开腹 腹腔镜 脾门淋巴结清扫 进展期胃癌 近期疗效 生存分析 

分 类 号：R735.2[医药卫生—肿瘤]