不同胃周动脉类型胃癌患者围手术期指标及预后分析  

Prognostic Analysis of Perioperative Indicators in Gastric Cancer Patients with Different Types of Perigastric Arteries

作　　者：孙跃勋 SUN Yuexun(Shangqiu Municipal Hospital,Shangqiu,476000)

机构地区：[1]河南省商丘市立医院,476000

出　　处：《实用癌症杂志》2024年第5期789-792,共4页The Practical Journal of Cancer

摘　　要：目的分析不同胃周动脉类型胃癌患者围手术期指标及预后分析。方法回顾性分析68例胃癌患者的病历资料,全部患者于手术前均应用CT血管造影(CTA)与三维重建措施对胃周动脉行准确分型,患者均行腹腔镜胃癌D2根治术;统计分析不同胃周动脉类型对胃癌患者围手术期结果与其预后的影响。结果68例患者经CTA明确分型,其中Ⅰ型42例(61.76%)、Ⅱ型7例(10.29%)、Ⅲ型5例(7.35%)、Ⅳ型6例(8.82%)、Ⅴ型3例(4.41%)、Ⅵ型3例(4.41%)、Ⅶ型2例(2.94%),将Ⅰ型患者纳入对照组,Ⅱ~Ⅵ型患者纳入变异组。不同胃周动脉类型胃癌患者的术中出血量、淋巴结清扫数目、术后引流量、手术与住院时间、并发症相比,差异无统计学意义(P>0.05);而Ⅰ型患者的术中血管损伤率低于其余类型患者,差异有统计学意义(P<0.05)。Kaplan-Meier结果显示:变异组2年生存率[69.23%(18/26)]与对照组2年生存率[83.33%(35/42)]相当,差异无统计学意义(P>0.05)。结论胃周动脉变异的患者,其术中的血管损伤概率较高,临床需予以高度重视。术前需熟练掌控胃癌患者的不同胃周动脉类别,进而确保手术的精细化,最大程度地减少血管损伤的发生风险。Objective To analyze the perioperative indicators and prognosis of gastric cancer patients with different types of perigastric arteries.Methods A retrospective analysis was conducted on the medical records of 68 patients with gastric cancer.All patients underwent accurate classification of the gastric artery using CT angiography(CTA)and three-dimensional reconstruction measures before surgery.All patients underwent laparoscopic D2 radical gastrectomy for gastric cancer;Statistical analysis of the impact of different types of perigastric arteries on perioperative outcomes and prognosis in gastric cancer patients.Results 68 patients were clearly classified by CTA,including 42 cases of type IⅠ(61.76%),7 cases of type Ⅱ(10.29%),5 cases of type Ⅲ(7.35%),6 cases of type Ⅳ(8.82%),3 cases of type Ⅴ(4.41%),3 cases of type Ⅵ(4.41%),and 2 cases of type Ⅷ(2.94%).Type Ⅰ patients were included in the control group,and type Ⅱ-Ⅵ patients were included in the variant group.There was no statistically significant difference in intraoperative bleeding,number of lymph node dissection,postoperative drainage volume,surgical and hospitalization time,and complications among patients with gastric cancer of different types of perigastric arteries(P>0.05);The intraoperative vascular injury rate in type I patients was lower than that in other types of patients,with a statistically significant difference(P<0.05).The Kaplan Meier results showed that the 2-year survival rate of the mutation group[69.23%(18/26)]was comparable to that of the control group[83.33%(35/42)],with no statistically significant difference(P>0.05).Conclusion Patients with variations in the gastric artery have a higher probability of intraoperative vascular damage,which should be highly valued in clinical practice.Before surgery,it is necessary to proficiently control the different types of gastric artery in gastric cancer patients,in order to ensure the refinement of surgery and minimize the risk of vascular damage.

关 键 词：胃癌 胃周类型 预后 血管损伤 

分 类 号：R735.2[医药卫生—肿瘤]