SOX新辅助化疗后腹腔镜胃癌D2根治术与常规根治术治疗进展期胃癌的近期随访比较  

Comparison of recent follow-up between laparoscopic D2 radical surgery and conventional radical surgery for advanced gastric cancer after SOX neoadjuvant chemotherapy

作　　者：许杰[1] 李亚俊[2] 冯义文 Xu Jie;Li Yajun;Feng Yiwen(Department of General Surgery,the First Afiliated Hospital of Xi'an Medical College,Xi'an Shaanxi Province 710000,China;Department of Gastroenterology,General Hospital of Ningxia Medical University,Yinchuan Ningxia Hui Autonomous Region 750004,China;Department of Pharmacy,Ankang Traditional Chinese Medicine Hospital,Ankang Shaanxi Province 725000,China)

机构地区：[1]西安医学院第一附属医院普外科,西安710000 [2]宁夏医科大学总院消化内科,银川750004 [3]安康市中医医院药剂科,陕西安康725000

出　　处：《中华普外科手术学杂志（电子版）》2024年第6期647-650,共4页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

基　　金：宁夏自然科学基金项目(2022AAC03525)。

摘　　要：目的探讨替吉奥联合奥沙利铂(SOX)新辅助化疗后腹腔镜胃癌D2根治术与常规开腹根治术治疗进展期胃癌患者近期随访结果的差异。方法回顾性分析2020年1月至2022年9月SOX新辅助化疗后接受手术的91例患者临床资料,46例采用腹腔镜胃癌D2根治术(腔镜组),45例采用开腹根治术(开腹组)。应用SPSS 27.0软件分析数据,围手术期指标、免疫功能等计量资料以(χ±s)描述,采用独立样本t检验;术后并发症等计数资料使用χ^(2)检验;采用Kaplan-Meier曲线分析患者的生存情况。P<0.05为差异有统计学意义。结果腔镜组患者胃肠功能恢复时间、住院时间均短于开腹组,术中出血量少于开腹组,手术时间长于开腹组(P<0.05);两组患者淋巴结清扫数目比较,差异无统计学意义(P>0.05);腔镜组患者术后1d、3dCD4+、CD4+/CD8+水平均高于开腹组,CD8+低于开腹组(P<0.05);术后1d、3d腔镜组患者白细胞介素6(IL-6)、降钙素原、C反应蛋白(CRP)水平均低于开腹组(P<0.05);两组患者生存期比较,差异无统计学意义(P>0.05)。结论SOX新辅助化疗后腹腔镜胃癌D2根治术可获得与开腹根治术相当的近期疗效,但腹腔镜胃癌D2根治术具有术中出血量少,住院时间、胃肠功能恢复时间短,术后并发症少,应激反应更轻等优点。Objective To investigate the difference of recent follow-up results between laparoscopic D2 radical surgery and conventional open radical surgery in advanced gastric cancer patients treated with Ticeo combined with oxaliplatin(SOX)neoadjuvant chemotherapy.Methods Clinical data of 91 patients who underwent surgery after SOX neoadjuvant chemotherapy from January 2020 to September 2022 were retrospectively analyzed.46 patients underwent laparoscopic D2 radical resection for gastric cancer(endoscopy group)and 45 patients underwent laparotomy(laparotomy group).SPSS 27.0 software was used to analyze the data.Perioperative indicators,immune function and other measurement data were described by(χ±s),and independent sample t test was used.The statistical data of postoperative complications were measured byχ^(2) test.Kaplan-Meier curve was used to analyze the survival of the patients.P<0.05 was considered statistically significant.Results The time of gastrointestinal function recovery and hospital stay in laparoscopy group were shorter than those in laparotomy group,the amount of intraoperative blood loss was less than that in laparotomy group,and the operative time was longer than that in laparotomy group(P<0.05).There was no significant difference in the number of lymph nodes between the two groups(P>0.05).The levels of 3dCD4+and CD4+/CD8+in endoscopic group were higher than those in laparotomy group,and CD8+was lower than those in laparotomy group(P<0.05).The levels of interleukin-6(IL-6),procalcitonin and C-reactive protein(CRP)in 1d and 3d endoscopic group were lower than those in open group(P<0.05).There was no significant difference in survival time between the two groups(P>0.05).Conclusion Laparoscopic D2 radical surgery for gastric cancer after SOX neoadjuvant chemotherapy can achieve short-term efficacy comparable to that of open radical surgery,but laparoscopic D2 radical surgery for gastric cancer has the advantages of less intraoperative blood loss,length of hospital stay,short recovery time of gastrointest

关 键 词：胃肿瘤 腹腔镜 替吉奥 奥沙利铂 新辅助化疗 手术后并发症 

分 类 号：R735.2[医药卫生—肿瘤]