胃癌微创D2根治术并发症的防治研究  

Study on the Prevention and Treatment of Complications of Minimally Invasive D2 Resection for Gastric Cancer

作　　者：林宝行[1] 叶进军[1] 闫玉矿[1] 李德宁[1] 陶绪雄[1] 

机构地区：[1]广东省深圳市龙岗中心医院,518116

出　　处：《实用癌症杂志》2015年第6期911-913,共3页The Practical Journal of Cancer

摘　　要：目的研究分析引起胃癌微创D2根治术并发症的相关因素,探讨防治并发症的有效方法。方法将78例胃癌患者,随机分配到微创组(腹腔镜辅助胃癌D2根治术)和开腹组(开腹全胃切除胃癌D2根治术)。比较2组患者的术后并发症,并对引起并发症危险因素进行Logistic回归分析。结果 2组的平均手术时间分别是微创组195.2 min和开腹组199.5 min,差异无统计学意义(P>0.05)。术中平均出血量分别是微创组101.2 ml和开腹组162.5 ml,肠道功能恢复时间分别是微创组2.5天和开腹组4天,平均住院时间分别是6.2天和15天,2组差异均有统计学意义(P<0.05)。并发症发生率分别是微创组23.8%(10例)和开腹组38.8%(14例)。通过Logistic回归分析,患者出现并发症的因素有:生活习惯(抽烟、喝酒、饮食不规律等)、肿瘤大小、肿瘤病理组织学分类、手术吻合方法等。结论腹腔镜辅助胃癌D2根治术伤口小,具有明显优势,术后并发症与患者不良生活习惯、肿瘤形态和手术方法等有关。Objective To study factors related to the complications of minimally invasive D2 resection for gastric cancer,and investigate the effective methods of prevention and treatment of complications. Methods 78 cases of gastric cancer patients were randomly divided into minimally invasive group( laparoscopic assisted radical resection of gastric cancer D2) and open laparotomy group( open total gastrectomy for gastric cancer D2 radical surgery). Postoperative complications,and the risk factors were analyzed by logistic regression analysis. Results The average operation time of minimally invasive group was 195. 2 min,and that of the open laparotomy group was 199. 5 min,there had no significant difference between the 2 groups( P > 0. 05). The average intraoperative bleeding volume of minimally invasive group was 101. 2 ml,and that of the open laparotomy group was162. 5 ml,intestinal function recovery time was 2. 5 days in minimally invasive group,and that of the open laparotomy group was 4days,average hospitalization time of minimally invasive group was 6. 2 days,and that of the open laparotomy group was 15 days,there was statistically significant difference between the 2 groups( P < 0. 05). The complication rate of minimally invasive group was 23. 8%( 10 cases),and that of the open laparotomy group was 38. 8%( 14 cases). Logistic regression analysis showed that factors for complications were living habits( smoking,drinking,diet is not the law),tumor size,pathological classification,operation method. Conclusion Laparoscopy assisted D2 radical gastrectomy for gastric cancer has small wound and obvious advantages,postoperative complications are related to bad habits,tumor morphology and operation method.

关 键 词：微创术 腹腔镜 胃癌 并发症 并发症危险因素 

分 类 号：R735.2[医药卫生—肿瘤]