腹腔镜近端胃癌根治术中拓展胃后间隙在肥胖患者中的应用研究  

Application of expanding retrogastric space in obese patients during laparoscopic radical resection of proximalgastriccancer

作　　者：吉顺富 汤晓燕 徐进 Ji Shunfu;Tang Xiaoyan;Xu Jin(Department of General Surgery,Hai'an Hospital of Traditional Chinese Medicine,Haian Jiangsu Province 226600,China)

机构地区：[1]海安市中医院普外科,江苏海安226600

出　　处：《中华普外科手术学杂志（电子版）》2024年第4期393-396,共4页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

基　　金：江苏省南通市科技计划项目(JCZ20110)。

摘　　要：目的探讨拓展胃后间隙在肥胖患者腹腔镜近端胃癌根治术(LPG)中的应用价值和可行性。方法基于前瞻性对照研究,纳人2021年1月至2023年12月行近端胃癌根治术的60例肥胖患者。按照数字表法随机分为两组,每组患者各30例。观察组患者行拓展胃后间隙的腹腔镜近端胃癌根治术;对照组行常规腹腔镜近端胃癌根治术。采用统计学软件SPSS22.0分析数据。围手术期指标和炎症指标等计量资料用(x±s)表示,行独立样本t检验;术后并发症等计数资料用[例(%)]表示,比较采用x^(2)检验。P<0.05表示差异有统计学意义。结果两组患者均完成腹腔镜近端胃癌根治术,无中转开腹。观察组患者手术时间及出血量较对照组明显减少,差异有统计学意义(P<0.05);术后3d观察组患者C反应蛋白(CRP)白介素-6(IL-6)肿瘤坏死因子-α(TNF-α)和白细胞(WBC)水平显著低于对照组,差异有统计学意义(P<0.05);观察组患者并发症总发生率虽低于对照组,但差异无统计学意义(P>0.05)。结论#拓展胃后间隙在肥胖患者腹腔镜近端胃癌根治术中可缩短手术时间,减少术中出血量,降低炎症水平,此方法在肥胖胃癌患者中安全可行。Objective To explore the application value and feasibility of expanding retrogastric space in obese patients undergoing laparoscopic radical gastrectomy(LPG)for proximal gastric cancer.Methods Based on a prospective controlled study,60 obese patients who underwent radical resection for proximal gastric cancer between January 2021 and December 2023 were included.They were divided into two groups according to numerical random table method,with 30 patients in each group.Observation group underwent laparoscopic radical gastrectomy to expand the retrogastric space.The control group underwent conventional laparoscopic radical gastrectomy of proximal gastric cancer.Statistical software SPSS 22.0 was used to analyze the data.Perioperative indexes and inflammatory indexes were represented by(x±s),and independent sample t test was performed.The statistical data of postoperative complications were represented by[cases(%)],and x^(2)test was used for comparison.P<0.05 indicated that the difference was statistically significant.Results All patients in both groups underwent laparoscopic radical gastrectomy without conversion to laparotomy.Operation time and blood loss in observation group were significantly reduced compared with control group,the difference was statistically significant(P<0.05).The levels of C-reactive protein(CRP),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)and white blood cell(WBC)in 3 d observation group were significantly lower than those in control group,with statistical significance(P<0.05).The total incidence of complications in observation group was lower than that in control group,but the difference was not statistically significant(P>0.05).Conclusion Expanding the retrogastric space can shorten the operation time,reduce intraoperative blood loss and reduce the level of inflammation in obese patients with proximal gastric cancer during laparoscopic radical gastrectomy.This method is safe and feasible in obese patients with gastric cancer.

关 键 词：胃肿瘤 肥胖症 腹腔镜 胃切除术 胃后间隙 

分 类 号：R735.2[医药卫生—肿瘤]