3D腹腔镜胃癌根治术临床疗效的前瞻性随机对照研究  

Clinical efficacy of 3D laparoscopic radical gastrectomy of gastric cancer:a prospective randomized controlled study

作　　者：陈秋贤 连明桥 连明杰 孙玉钦 吕陈彬 蔡丽生 徐乾辉 Chen Qiuxian;Lian Mingqiao;Lian Mingjie;Sun Yuqin;Lyu Chenbin;Cai Lisheng;Xu Qianhui(Department of Gastric Surgery,Zhangzhou Affiliated Hospital of Fujian Medical University,Zhangzhou 350600,China)

机构地区：[1]福建医科大学附属漳州市医院胃外科,漳州350600

出　　处：《中华消化外科杂志》2025年第3期367-373,共7页Chinese Journal of Digestive Surgery

基　　金：福建省卫生健康委员会科技计划项目(2023QNA087);福建省漳州市医院博士工作站攀登项目(PDB202416)。

摘　　要：目的探讨3D腹腔镜胃癌根治术的临床疗效。方法采用前瞻性随机对照研究方法。选取2022年1―12月福建医科大学附属漳州市医院收治的90例行完全腹腔镜胃癌根治术患者的临床资料,按随机数字表法将患者分为3D腹腔镜组和2D腹腔镜组,分别行3D或2D腹腔镜胃癌根治术。观察指标:(1)入组患者分组情况。(2)术中和术后情况。(3)术中主刀医师感受。正态分布的计量资料组间比较采用独立样本t检验。计数资料组间比较采用χ^(2)检验或Fisher确切概率法。等级资料组间比较采用非参数检验。结果(1)入组患者分组情况。筛选出符合条件的行完全腹腔镜胃癌根治术患者90例;男56例,女34例;年龄为(61±7)岁。90例患者随机分配至3D腹腔镜组和2D腹腔镜组各45例。两组患者性别、年龄、体质量指数、高血压、糖尿病、腹部手术史、手术方式、肿瘤部位、TNM分期比较,差异均无统计学意义(P>0.05),具有可比性。(2)术中和术后情况。3D腹腔镜组和2D腹腔镜组患者总手术时间分别为(196±12)min和(204±14)min,消化道重建时间分别为(81±8)min和(87±12)min,两组患者上述指标比较,差异均有统计学意义(t=-2.85、-2.43,P<0.05)。3D腹腔镜组中,3例患者出现术后并发症(腹腔感染1例、肠梗阻2例);2D腹腔镜组中,8例患者出现术后并发症(吻合口瘘2例、腹腔感染2例、肠梗阻4例),两组比较,差异无统计学意义(χ^(2)=2.59,P>0.05)。(3)术中主刀医师感受。术后由主刀医师完成问卷调查。3D腹腔镜组和2D腹腔镜组主刀医师图像质量感评分分别为(4.73±0.08)分和(4.46±0.09)分,手眼协调性评分分别为(4.60±0.09)分和(4.55±0.08)分,操作舒适性评分分别为(4.81±0.05)分和(4.62±0.08)分,用眼舒适度评分分别为(4.49±0.07)分和(4.68±0.07)分,两组患者上述指标比较,差异均有统计学意义(t=15.04、2.57、13.51、-12.88,P<0.05)。结论与2D腹腔镜比较,3D腹腔镜胃Objective To investigate the clinical efficacy of 3D laparoscopic radical gastrectomy of gastric cancer.Methods The prospective randomized controlled study was conducted.The clinical data of 90 patients undergoing total laparoscopic radical gastrectomy of gastric cancer in Zhangzhou Affiliated Hospital of Fujian Medical University from January to December 2022 were selected.Patients were randomly divided into the 3D laparoscopic group and the 2D laparoscopic group by the method of random number table.Patients underwent 3D or 2D laparoscopic radical gastrectomy of gastric cancer.Observation indicators:(1)grouping of enrolled patients;(2)intraoperative and postoperative situations;(3)feelings of the major surgeon during the operation.Comparison of measurement data with normal distribution between groups was conducted using the independent sample t test.Comparison of count data between groups wsa conducted using the chi-square test or Fisher exact probability.Comparison of ordinal data between groups was conducted using the nonparametric test.Results(1)Group of enrolled patients.A total of 90 patients eligible for total laparoscopic radical gastrectomy of gastric cancer were selected.There were 56 males and 34 females,aged(61±7)years.All 90 patients were randomly divided into the 3D laparoscopic group and the 2D laparoscopic group,with 45 cases in each group.There was no significant difference in gender,age,body mass index,hypertension,diabetes mellitus,history of abdominal surgery,surgical method,tumor site and TNM staging between the two groups(P>0.05),indicating comparability.(2)Intraoperative and postoperative situations.The operation time of the 3D laparoscopic group and the 2D laparoscopic group were(196±12)minutes and(204±14)minutes,respectively.The digestive tract reconstruction time of the 3D laparoscopic group and the 2D laparoscopic group were(81±8)minutes and(87±12)minutes,respectively.There were significant differences in operation time and digestive tract reconstruction time between the two groups

关 键 词：胃肿瘤 3D腹腔镜 2D腹腔镜 全腹腔镜 胃癌根治术 手术并发症 

分 类 号：R735.2[医药卫生—肿瘤]