新辅助化疗后全腔镜与腹腔镜辅助根治性全胃切除术近期临床疗效对比研究  

A comparative study on the short-term clinical efficacy of totally laparoscopic and laparoscopic-assisted total gastrectomy after neoadjuvant chemotherapy

作　　者：卫江鹏 柳金强 郭欣 杨西胜 贾瀚翔 董丹红 李晓华 季刚 WEI Jiang-peng;LIU Jin-qiang;GUO Xin(Department of Gastrointestinal Surgery,the First Affiliated Hospital,Air Force Medical University,Xi'an 710032,China)

机构地区：[1]空军军医大学第一附属医院胃肠外科,陕西西安710032

出　　处：《腹腔镜外科杂志》2023年第1期30-33,40,共5页Journal of Laparoscopic Surgery

摘　　要：目的:比较新辅助化疗后全腔镜与腹腔镜辅助根治性全胃切除术的近期疗效。方法:回顾性收集2020年1月至2022年12月行新辅助化疗并接受标准完全腹腔镜与腹腔镜辅助根治性全胃切除术的144例进展期胃上部癌患者的临床资料,其中完全腹腔镜组56例,腹腔镜辅助组88例。结果:两组患者术前资料差异无统计学意义(P>0.05)。全腹腔镜组术后3 d CRP值更低[(23.83±6.06)mg/L vs.(27.25±7.28)mg/L,P=0.004],术后排气时间更短[(2.82±0.74)d vs.(3.16±0.79)d,P=0.011],切口长度更小[(4.82±0.99)cm vs.(6.47±1.36)cm,P<0.001],进食更早[(3.03±0.81)d vs.(3.42±0.94)d,P=0.013]。两组手术时间、术中出血量、术后排便时间、住院时间、住院费用及术后并发症差异均无统计学意义。结论:完全腹腔镜根治性全胃切除术应用于胃上部癌新辅助治疗后是安全、可行的,并具有创伤小、康复快等优点。Objective:To compare the short-term clinical efficacy of totally laparoscopic total gastrectomy(TLTG)and laparoscopic-assisted total gastrectomy(LATG)after neoadjuvant chemotherapy.Methods:The clinical data of 144 patients with advanced upper gastric cancer who received neoadjuvant chemotherapy and standard TLTG or LATG from Jan.2020 to Dec.2022 were retrospectively collected,including 56 patients in the TLTG group and 88 patients in the LATG group.Results:There was no statistical difference between the two groups in general preoperative data(P>0.05).In the TLTG group,the CRP value was lower on the 3rd postoperative day[(23.83±6.06)mg/L vs.(27.25±7.28)mg/L,P=0.004],the time of exhaust was shorter[(2.82±0.74)d vs.(3.16±0.79)d,P=0.011],the length of incision was shorter[(4.82±0.99)cm vs.(6.47±1.36)cm,P<0.001],and the eating was earlier[(3.03±0.81)d vs.(3.42±0.94)d,P=0.013].There was no significant difference between the two groups in terms of the operation time,intraoperative blood loss,postoperative defecation time,hospital stay,hospitalization costs and postoperative complications.Conclusions:TLTG is safe and feasible after neoadjuvant therapy for upper gastric cancer,and has the advantages of fewer trauma,less pain and faster recovery.

关 键 词：胃肿瘤 腹腔镜检查 新辅助化疗 疗效比较研究 

分 类 号：R735.2[医药卫生—肿瘤]