腹腔镜胃完整系膜切除术联合D2根治术治疗进展期胃癌患者的效果  

Effects of laparoscopic complete gastric mesangial resection combined with D2 radical surgery in treatment of patients with advanced gastric cancer

作　　者：李冰涛 LI Bingtao(Department of Surgery of Zhecheng County People’s Hospital,Shangqiu 476200 Henan,China)

机构地区：[1]柘城县人民医院外科,河南商丘476200

出　　处：《中国民康医学》2025年第6期39-42,共4页Medical Journal of Chinese People’s Health

摘　　要：目的:观察腹腔镜胃完整系膜切除术联合D2根治术治疗进展期胃癌患者的效果。方法:回顾性分析2020年1月至2023年10月该院收治的85例进展期胃癌患者的临床资料,根据手术方式不同将其分为对照组42例和观察组43例。对照组采用腹腔镜D2根治术治疗,观察组采用腹腔镜胃完整系膜切除术联合D2根治术治疗,比较两组围手术期指标(手术时间、术中出血量、淋巴结清扫个数、术后首次排气时间、术后首次下床活动时间、住院时间)水平,术后6个月并发症发生率,术后3、6个月复发率、病死率,以及手术前后生命质量[生活质量综合评定问卷-74(GQOLI-74)]评分。结果:观察组术中出血量少于对照组,淋巴结清扫个数多于对照组,住院时间短于对照组,差异均有统计学意义(P<0.05);两组手术时间、术后首次排气时间、术后首次下床活动时间比较,差异均无统计学意义(P>0.05);两组术后并发症发生率比较,差异无统计学意义(P>0.05);观察组术后6个月复发率低于对照组,差异有统计学意义(P<0.05);两组术后3个月复发率及术后3、6个月病死率比较,差异均无统计学意义(P>0.05);术后6个月,两组躯体功能、心理功能、社会功能、物质生活状态等GQOLI-74各维度评分均高于术前,且观察组高于对照组,差异有统计学意义(P<0.05)。结论:腹腔镜胃完整系膜切除术联合D2根治术治疗进展期胃癌患者可提高生命质量评分,减少术中出血量,增加淋巴结清扫个数,缩短住院时间,降低复发率,效果优于单纯腹腔镜D2根治术治疗。Objective:To observe effects of laparoscopic complete gastric mesangial resection combined with D2 radical surgery in treatment of patients with advanced gastric cancer.Methods:The clinical data of 85 patients with advanced gastric cancer admitted to this hospital from January 2020 to October 2023 were retrospectively analyzed.According to the different surgical methods,they were divided into 42 cases in the control group and 43 cases in the observation group.The control group was treated with laparoscopic D2 radical surgery,while the observation group was treated with laparoscopic gastric complete mesangial resection combined with laparoscopic D2 radical surgery.The perioperative indexes(operation time,intraoperative blood loss,number of lymph node dissected,first postoperative exhaust time,first postoperative out-of-bed time,hospitalization time)levels,the incidence of complications 6 months after the surgery,the recurrence rates and the mortality rates 3 and 6 months after the surgery,and he quality of life[general quality of life inventory-74(GQOLI-74)]scores before and after the surgery were compared between the two groups.Results:The intraoperative blood loss in the observation group was less than that in the control group,the number of lymph node dissected was more than that in the control group,the hospitalization time was shorter than that in the control group,and the differences were statistically significant(P<0.05).There was no significant difference in the operation time,the first postoperative exhaust time and the first postoperative ambulation time between the two groups(P>0.05).There was no significant difference in the incidence of postoperative complications between the two groups(P>0.05).The recurrence rate of the observation group was lower than that of the control group 6 months after the surgery,and the difference was statistically significant(P<0.05).6 months after the surgery,the GQOLI-74 scores of physical function,psychological function,social function and material life status in the two

关 键 词：进展期胃癌 腹腔镜 D2根治术 胃完整系膜切除术 生命质量 复发率 淋巴结清扫 

分 类 号：R735.2[医药卫生—肿瘤]