腹腔镜辅助胃癌根治术治疗胃癌患者临床疗效分析
摘要
目的探讨腹腔镜辅助胃癌根治术治疗胃癌患者临床疗效。方法对远安县人民医院2013年6月至2015年12月行胃癌根治术治疗的110例胃癌患者临床资料进行回顾性分析。根据手术方式不同分为辅助组(62例)和开腹组(48例),对辅助组、开腹组及辅助组TNM分期Ⅰ期(14例)、Ⅱ期(15例)、Ⅲ期(33例)患者术中、术后及并发症相关指标情况进行比较。结果两组手术时间、淋巴结扫清数目比较,差异无统计学意义(P> 0. 05)。辅助组切口长度、出血量、肛门排气时间、胃管留置时间、下床活动时间、初次进食时间、住院时间均小于开腹组(P <0. 05)。辅助组并发症总发生率为11. 29%,显著低于开腹组的27. 08%(P <0. 05)。辅助组Ⅰ期患者淋巴结扫清数目显著小于Ⅲ期患者(P <0. 05)。不同分期患者并发症总发生率比较,差异无统计学意义(P> 0. 05)。结论腹腔镜辅助胃癌根治术治疗胃癌患者临床疗效显著,优于传统开腹手术,对TNM分期Ⅰ～Ⅲ期胃癌患者治疗作用相当。
引文
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[13]李政焰,石彦,赵永亮,等.腹腔镜与开腹进展期远端胃癌D2根治术疗效对比[J].中华胃肠外科杂志,2016,19(5):530-534.
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[15]杨宏,崔明,邢加迪,等.腹腔镜辅助胃癌根治术的临床疗效[J].中华消化外科杂志,2016,15(3):234-240.
[16] Mikami K,Hirano Y,Futami K,et al. Expansion of lymph node metastasis in mixed-type submucosal invasive gastric cancer[J].Asian J Surg,2018,41(5):462-466.
[17] Kim JH,Jun KH,Chin HM. Short-term surgical outcomes of laparoscopy-assisted versus totally laparoscopic Billroth-II gastrectomy for gastric cancer:a matched-cohort study[J]. BMC Surg,2017,17(1):45.
[18]王进超.进展期胃癌患者应用腹腔镜与开腹胃癌根治术治疗的临床疗效对比[J].现代消化及介入诊疗,2016,21(2):310-312.
[19]应敏刚,杨春康.腹腔镜胃癌根治术并发症的防治策略[J].临床外科杂志,2016,24(11):819-821.
[20] Ikoma N,Blum M,Chiang YJ,et al. Race is a risk for lymph node metastasis in patients with gastric cancer[J]. Ann Surg Oncol,2017,24(4):960-965.
[2] Lee SR,Kim HO,Son BH,et al. Laparoscopic-assisted total gastrectomy versus open total gastrectomy for upper and middle gastric cancer in short-term and long-term outcomes[J]. Surg Laparosc Endosc Percutan Tech,2014,24(3):277-282.
[3]邓莎,陈建洪.腹腔镜胃癌根治术二氧化碳气腹对Pa CO2及PETCO2的影响[J].南昌大学学报,2014,54(10):48-50.
[4] Sano T,Coit DG,Kim HH,et al. Proposal of a new stage grouping of gastric cancer for TNM classification:international gastric cancer association staging project[J]. Gastric Cancer,2017,20(2):217-225.
[5] Martin M,Custodio A,García-Girón C,et al. Seom guidelines for the treatment of gastric cancer 2015[J]. Clin Transl Oncol,2015,17(12):996-1004.
[6]卫庆文,张梦娇,易丹.腹腔镜及开腹远端胃癌D2根治术治疗进展期胃癌的疗效及术后相关并发症的比较[J].现代消化及介入诊疗,2017,22(1):82-85.
[7]刘江文,孙琳,仝德峰,等.远端进展期胃癌腹腔镜辅助与开腹D2根治术淋巴结清扫的临床对照研究[J].中国微创外科杂志,2014,14(11):981-983.
[8] Zong L,Abe M,Seto Y,et al. The challenge of screening for early gastric cancer in China[J]. Lancet,2016,388(10060):2606.
[9] Bencivenga M,Verlato G,Han DS,et al. Validation of two prognostic models for recurrence and survival after radical gastrectomy for gastric cancer[J]. Br J Surg,2017,104(9):1235-1243.
[10] Kim DJ,Park CH,Kim W,et al. Safety of laparoscopic radical gastrectomy in gastric cancer patients with liver cirrhosis[J]. Surg Endosc,2017,31(10):3898-3904.
[11]蒋晖,杜军,顾纪明,等.腹腔镜胃癌根治术与开腹胃癌根治术治疗老年胃癌疗效比较[J].新乡医学院学报,2016,33(9):770-773.
[12]高金辉,李建国,蔡铭智,等.腹腔镜辅助与开腹胃癌根治术的中期疗效比较[J].中国微创外科杂志,2015,15(7):597-600.
[13]李政焰,石彦,赵永亮,等.腹腔镜与开腹进展期远端胃癌D2根治术疗效对比[J].中华胃肠外科杂志,2016,19(5):530-534.
[14] Lu J,Zheng CH,Zheng HL,et al. Randomized,controlled trial comparing clinical outcomes of 3D and 2D laparoscopic surgery for gastric cancer:an interim report[J]. Surg Endosc,2017,31(7):2939-2945.
[15]杨宏,崔明,邢加迪,等.腹腔镜辅助胃癌根治术的临床疗效[J].中华消化外科杂志,2016,15(3):234-240.
[16] Mikami K,Hirano Y,Futami K,et al. Expansion of lymph node metastasis in mixed-type submucosal invasive gastric cancer[J].Asian J Surg,2018,41(5):462-466.
[17] Kim JH,Jun KH,Chin HM. Short-term surgical outcomes of laparoscopy-assisted versus totally laparoscopic Billroth-II gastrectomy for gastric cancer:a matched-cohort study[J]. BMC Surg,2017,17(1):45.
[18]王进超.进展期胃癌患者应用腹腔镜与开腹胃癌根治术治疗的临床疗效对比[J].现代消化及介入诊疗,2016,21(2):310-312.
[19]应敏刚,杨春康.腹腔镜胃癌根治术并发症的防治策略[J].临床外科杂志,2016,24(11):819-821.
[20] Ikoma N,Blum M,Chiang YJ,et al. Race is a risk for lymph node metastasis in patients with gastric cancer[J]. Ann Surg Oncol,2017,24(4):960-965.