右侧前入路与左侧后入路腹腔镜远端胃癌根治术的应用效果对比  

Comparison of therapeutic effect of laparoscopic radical gastrectomy via right anterior approach and via left posterior approach

作　　者：陈林涛[1] 周学伟[1] 刘长生[1] 张一帆[1] Chen Lintao;Zhou Xuewei;Liu Changsheng;Zhang Yifan(Department of Gastrointestinal Surgery,Nanyang Second General Hospital,Nanyang 473012,China)

机构地区：[1]南阳市第二人民医院胃肠外科,南阳473012

出　　处：《中国实用医刊》2023年第16期44-47,共4页Chinese Journal of Practical Medicine

摘　　要：目的比较右侧前入路与左侧后入路腹腔镜远端胃癌根治术的应用效果。方法抽取2019年3月至2022年2月南阳市第二人民医院收治的胃癌患者68例,按照随机数字表法分为对照组和研究组,每组34例。对照组采用左侧后入路腹腔镜远端胃癌根治术治疗,研究组采用右侧前入路腹腔镜远端胃癌根治术治疗。比较两组围术期指标、术后恢复情况、手术前后血清炎症因子[超敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)]水平、并发症发生率及复发率。结果研究组手术时间短于对照组,术中出血量少于对照组,淋巴结清扫数目多于对照组(P<0.05);研究组下床活动时间、拔除胃管时间、排气恢复时间、住院时间均短于对照组(P均<0.05)。术后24 h,研究组hs-CRP、IL-6水平均低于对照组(P均<0.05)。研究组并发症发生率及复发率(8.82%,3/34;2.94%,1/34)与对照组(14.71%,5/34;11.76%,4/34)比较差异未见统计学意义(P>0.05)。结论与左侧后入路相比,右侧前入路腹腔镜远端胃癌根治术治疗胃癌的效果更好,能减少术中出血量,增加淋巴结清扫数目,缩短患者下床活动和排气恢复时间,有效缓解机体炎症,且能降低并发症发生率和复发率。Objective To compare the application effect of laparoscopic radical gastrectomy via right anterior approach and via left posterior approach.Methods A total of 68 patients with gastric cancer treated in Nanyang Second General Hospital from March 2019 to February 2022 were selected,and they were divided into control group and study group according to random number table method,with 34 cases in each group.The control group was treated by laparoscopic radical gastrectomy via left posterior approach,and the study group was treated by laparoscopic radical gastrectomy via right anterior approach.The perioperative indicators,postoperative recovery,preoperative and postoperative levels of serum inflammatory factors,including hypersensitivity C-reactive protein(hs-CRP)and interleukin-6(IL-6),complication rates,and recurrence rate were compared between the two groups.Results Compared with the control group,the study group had shorter operation time,less intraoperative blood loss and more lymph node dissected(P<0.05).Compared with the control group,the study group had shorter time of out-of-bed activity,gastric tube removal,exhaust recovery and hospital stay(all P<0.05).Compared with the control group,the levels of hs-CRP and IL-6 in study group were lower 24 hours after surgery(all P<0.05).There was no significant difference in the complication rate and recurrence rate between the study group(8.82%,3/34;2.94%,1/34)and the control group(14.71%,5/34;11.76%,4/34),P>0.05.Conclusions Compared with left posterior approach,laparoscopic radical gastrectomy via right anterior approach is more effective in the treatment of gastric cancer,which can reduce intraoperative blood loss,increase the number of lymph nodes dissected,shorten the time of out-of-bed activity and exhaust recovery,effectively relieve body inflammation,and reduce the incidence of complications and recurrence.

关 键 词：胃癌 胃癌根治术 腹腔镜 右侧前入路 左侧后入路 

分 类 号：R735.2[医药卫生—肿瘤]