[1]万玉峰.全腹腔镜胃部分离断后胃肠吻合术对老年胃癌合并幽门梗阻的远期临床疗效[J].医学信息,2023,36(02):116-119.[doi:10.3969/j.issn.1006-1959.2023.02.023]
　WAN Yu-feng.Long-term Clinical Efficacy of Total Laparoscopic Gastrointestinal Anastomosis After Gastric Separation in Elderly Patients with Gastric Cancer Complicated with Pyloric Obstruction[J].Journal of Medical Information,2023,36(02):116-119.[doi:10.3969/j.issn.1006-1959.2023.02.023]
点击复制

全腹腔镜胃部分离断后胃肠吻合术对老年胃癌合并幽门梗阻的远期临床疗效()
分享到：

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
36卷
期数:
2023年02期
页码:
116-119
栏目:
临床研究
出版日期:
2023-01-15

文章信息/Info

Title:
Long-term Clinical Efficacy of Total Laparoscopic Gastrointestinal Anastomosis After Gastric Separation in Elderly Patients with Gastric Cancer Complicated with Pyloric Obstruction
文章编号:
1006-1959（2023）02-0116-04
作者:
万玉峰
（佳木斯市中心医院普外一科，黑龙江 佳木斯 154003）
Author(s):
WAN Yu-feng
(The First Department of General Surgery,Jiamusi Central Hospital,Jiamusi 154003,Heilongjiang,China)
关键词:
胃癌; 幽门梗阻; 腹腔镜; 胃部分离断术; 胃肠吻合术
Keywords:
astric cancer; Pyloric obstruction; Laparoscopic; Gastric dissection; Gastrointestinal anastomosis
分类号:
R735.2
DOI:
10.3969/j.issn.1006-1959.2023.02.023
文献标志码:
A
摘要:
目的 研究全腹腔镜胃部分离断后胃肠吻合术对老年胃癌合并幽门梗阻的远期临床疗效。方法 选取2018年8月-2020年10月我院接诊的72例老年胃癌合并幽门梗阻患者为研究对象，采用随机数字表法分为观察组和对照组，各36例。对照组采用开腹手术治疗，观察组采用全腹腔镜胃部分离断后胃肠吻合术治疗，比较两组临床手术指标、并发症发生率、随访2年生存率和幽门梗阻复发率、应激反应、生存质量。结果 两组手术时间比较，差异无统计学意义（P＞0.05），观察组术中出血量、术后下床活动时间、胃管留置时间均小于对照组（P＜0.05）；观察组并发症发生率为8.33%，低于对照组的19.44%（P＜0.05）；随访2年，观察组生存率为100.00%，高于对照组的83.33%，幽门梗阻复发率为2.78%，低于对照组的19.44%（P＜0.05）；两组C反应蛋白（CRP）、白介素-6（IL-6）水平均升高，但观察组低于对照组（P＜0.05）；两组生存质量水平均高于术前，且观察组高于对照组（P＜0.05）。结论 全腹腔镜胃部分离断后胃肠吻合术治疗老年胃癌合并幽门梗阻患者可改善患者手术指标、减少应激反应，提高患者生存质量和2年生存率，且可降低并发症发生率，具有较理想的远期疗效。
Abstract:
Objective To study the long-term clinical efficacy of total laparoscopic gastrointestinal anastomosis after gastric separation in elderly patients with gastric cancer complicated with pyloric obstruction.Methods A total of 72 elderly patients with gastric cancer complicated with pyloric obstruction admitted to our hospital from August 2018 to October 2020 were selected as the research objects. They were divided into observation group and control group by random number table method, with 36 cases in each group. The control group was treated with laparotomy, and the observation group was treated with total laparoscopic gastrointestinal anastomosis after gastric separation. The clinical operation indexes, complication rate, 2-year survival rate, recurrence rate of pyloric obstruction, stress response and quality of life were compared between the two groups.Results There was no significant difference in operation time between the two groups (P>0.05). The intraoperative blood loss, postoperative ambulation time and gastric tube indwelling time in the observation group were less than those in the control group (P<0.05). The incidence of complications in the observation group was 8.33%, which was lower than 19.44% in the control group (P<0.05). After 2 years of follow-up, the survival rate of the observation group was 100.00%, which was higher than 83.33% of the control group, and the recurrence rate of pyloric obstruction was 2.78%, which was lower than 19.44% of the control group (P<0.05). The levels of C-reactive protein (CRP) and interleukin-6 (IL-6) in the two groups increased, and those in the observation group were lower than those in the control group (P<0.05). The quality of life of the two groups was higher than that before operation, and that of the observation group was higher than that of the control group (P<0.05).Conclusion Total laparoscopic gastric separation after gastrointestinal anastomosis in the treatment of elderly patients with gastric cancer complicated with pyloric obstruction can improve the surgical indicators, reduce stress response, improve the quality of life and 2-year survival rate, and reduce the incidence of complications, with ideal long-term efficacy.

参考文献/References:

[1]姚震旦,崔明,邢加迪,等.腹腔镜辅助全胃切除术在65岁以上胃癌患者中的应用[J].中华胃肠外科杂志,2018,21(12):1396-1402.[2]葛廷建,王敬华.腹腔镜与开腹胃癌根治术疗效及对机体免疫功能影响的比较[J].中国肿瘤临床与康复,2017,24(10):1190-1193.[3]甄雄严,宋雪云,张文缙,等.两种术式治疗胃癌合并幽门梗阻的近远期疗效比较[J].实用临床医药杂志,2017,21(15):125-127.[4]王辅宇.胃肠、胆肠、肠肠吻合术式治疗胃远端晚期癌合并幽门梗阻和胆总管梗阻临床疗效[J].黑龙江医学,2018,42(10):958-959. [5]黄天臣,肖建安,王青兵,等.内镜支架置入与手术治疗不可切除胃癌引起幽门梗阻的疗效对比[J].中华普通外科杂志,2017,32(10):820-823.[6]郭豫吉,王春荣,金颖.PDOX联合细胞减灭术加腹腔热灌注化疗治疗VX-2胃癌并幽门梗阻的试验研究[J].现代消化及介入诊疗,2018,23(5):544-547. [7]沈云赋,何永生,周萃阶,等.不同手术方式 在腹腔镜辅助根治性全胃切除术治疗超重胃癌患者的临床疗效及安全性分析[J].现代消化及介入诊疗,2019,24(9):1003-1006.[8]中华医学会肿瘤学分会,中华医学会杂志社.中华医学会胃癌临床诊疗指南 (2021 版)[J].中华医学杂志,2022,102(16):1169-1189[9]曹押宏.根治术与姑息切除术对胃癌胃急性穿孔、合并幽门梗阻及急性大出血的疗效比较[J].实用癌症杂志,2017,31(11):1841-1844．[10]蒋天宇,马君俊,臧潞,等.胃空肠转流术联合转化治疗后根治性切除治疗胃癌合并幽门梗阻的临床疗效[J].中华消化外科杂志,2021,20(9):967-973.[11]张震,苏妍卓,李畅,等.胃肠吻合术联合术后化疗治疗不能根治切除伴幽门梗阻的进展期胃癌[J].中国普外基础与临床杂志,2019,26(11):1342-1345.[12]张一帆.全腹腔镜下远端胃切除术联合三角吻合术治疗胃癌的临床研究[J].实用癌症杂志,2021,36(9):1521-1523,1527.[13]Urade M,Fujimoto S.Ectopic pancreatitis in the antral stomach causing gastric outlet obstruction: a case of successful resection [J].Clin J Gastroenterol,2020,13(3):465-471[14]刘昊,徐泉,马福海,等.全腹腔镜胃部分离断后胃肠吻合术 治疗胃癌合并幽门梗阻的临床效果[J].中华肿瘤杂志,2020,42(6):445-448. [15]吴楚营,叶凯,许建华,等.改良 Overlap 吻合与传统辅助切口吻合在腹腔镜全胃根治术中的临床疗效[J].中华消化外科杂志,2020,19(9):988-994.[16]田庆林,李阳,陈晓峰.腹腔镜远端胃癌根治术毕Ⅱ式联合Braun 吻合术对胃癌肠道屏障功能血清炎性因子水平的影响[J].河北医学,2020,26(1):41-45.[17]张洪志,任远,张旭,等.胃癌伴幽门梗阻患者的腹腔镜手术价值探讨[J].实用临床医药杂志,2020,24(21):9-11[18]张峰,朱求实,王满贞,等.毕Ⅱ式吻合术联合改良 Braun 吻合术对腹腔镜远端胃癌切除术患者的临床疗效及安全性[J].癌症进展,2019,17(3):315-317.[19]李婷,赵平武.完全腹腔镜胃癌根治术腔内食管空肠侧侧吻合的临床应用研究[J].腹腔镜外科杂志,2018,23(10):761-765.[20]唐滔,叶进军,李德宁,等.全腹腔镜下改良三角吻合技术在胃癌根治术中临床应用[J].中国现代普通外科进展,2018,21(6):441-443,465.

相似文献/References:

[1]尹晓华,刘重元,黄 琳,等.胃癌中lncRNAs的研究进展[J].医学信息,2018,31(03):10.[doi:10.3969/j.issn.1006-1959.2018.03.004]
　YIN Xiao-hua,LIU Zhong-yuan,HUANG Lin,et al.Research Progress of lncRNAs in Gastric Cancer[J].Journal of Medical Information,2018,31(02):10.[doi:10.3969/j.issn.1006-1959.2018.03.004]
[2]芮昆昆,章 波,邰小华,等.基质金属蛋白酶2与蛋白磷酸酶2A的癌性抑制因子在胃癌中的研究进展[J].医学信息,2018,31(03):21.[doi:10.3969/j.issn.1006-1959.2018.03.007]
　RUI Kun-kun,ZHANG Bo,TAI Xiao-hua,et al.The Research Progress of Matrix Metalloproteinase 2 and Cancer Inhibitor of Protein Phosphatase 2A in Gastric Cancer[J].Journal of Medical Information,2018,31(02):21.[doi:10.3969/j.issn.1006-1959.2018.03.007]
[3]段 巍.1例晚期胃癌化疗并发嗜血细胞综合征患者的护理[J].医学信息,2018,31(10):181.[doi:10.3969/j.issn.1006-1959.2018.10.063]
　DUAN Wei.Nursing Care of a Case of Advanced Gastric Carcinoma with Hemophagocytic Syndrome after Chemotherapy[J].Journal of Medical Information,2018,31(02):181.[doi:10.3969/j.issn.1006-1959.2018.10.063]
[4]潘理会,李育庄,李春辉.胃癌与高凝血状态关系的研究现状[J].医学信息,2018,31(11):15.[doi:10.3969/j.issn.1006-1959.2018.11.005]
　PAN Li-hui,LI Yu-zhuang,LI Chun-hui.Research Status of the Relationship between Gastric Carcinoma and Hypercoagulable State[J].Journal of Medical Information,2018,31(02):15.[doi:10.3969/j.issn.1006-1959.2018.11.005]
[5]李虹霞,刘伏山.慢性萎缩性胃炎的中西医治疗[J].医学信息,2022,35(11):29.[doi:10.3969/j.issn.1006-1959.2022.11.009]
　LI Hong-Xia,LIU Fu-shan.Treatment of Chronic Atrophic Gastritis with Traditional Chinese and Western Medicine[J].Journal of Medical Information,2022,35(02):29.[doi:10.3969/j.issn.1006-1959.2022.11.009]
[6]梁延洋,程艳娜,华柏慧,等.胃癌合并2型糖尿病术后血糖改善的临床观察[J].医学信息,2018,31(17):187.[doi:10.3969/j.issn.1006-1959.2018.17.061]
　LIANG Yan-yang,CHENG Yan-na,HUA Bai-hui,et al.Clinical Observation of Postoperative Blood Glucose Improvement in Patients with Gastric Cancer Complicated with Type 2 Diabetes Mellitus[J].Journal of Medical Information,2018,31(02):187.[doi:10.3969/j.issn.1006-1959.2018.17.061]
[7]林跃韩,许庆文.腹腔镜uncut Roux-en-Y吻合与传统吻合方式的研究进展[J].医学信息,2018,31(22):31.[doi:10.3969/j.Ⅰssn.1006-1959.2018.22.010]
　LIN Yue-han,XU Qing-wen.Research Progress of Laparoscopic uncut Roux-en-Y Anastomosis and Traditional Anastomosis[J].Journal of Medical Information,2018,31(02):31.[doi:10.3969/j.Ⅰssn.1006-1959.2018.22.010]
[8]马玉涛,石文娜,李晓林,等.免疫荧光法检测FSHR与GnRHR在胃癌组织中的分布及其共定位研究[J].医学信息,2018,31(23):79.[doi:10.3969/j.issn.1006-1959.2018.23.022C]
　MA Yu-tao,SHI Wen-na,LI Xiao-lin,et al.Study on the Distribution and Co-localization of FSHR and GnRHR in Gastric Cancer Tissues by Immunofluorescence Assay[J].Journal of Medical Information,2018,31(02):79.[doi:10.3969/j.issn.1006-1959.2018.23.022C]
[9]赵 静.血浆纤维蛋白原和CA724水平在胃癌患者的变化及临床意义[J].医学信息,2018,31(24):82.[doi:10.3969/j.issn.1006-1959.2018.24.021]
　ZHAO Jing.Changes and Clinical Significance of Plasma Fibrinogen and CA724 Levels in Patients with Gastric Cancer[J].Journal of Medical Information,2018,31(02):82.[doi:10.3969/j.issn.1006-1959.2018.24.021]
[10]万 芳.以贫血为首发症状的消化道恶性肿瘤临床分析[J].医学信息,2018,31(24):175.[doi:10.3969/j.issn.1006-1959.2018.24.054]
　WAN Fang.Clinical Analysis of Digestive Tract Malignancies with Anemia as the First Symptom[J].Journal of Medical Information,2018,31(02):175.[doi:10.3969/j.issn.1006-1959.2018.24.054]
[11]孙春阳,赵长海.全腹腔镜胃部分离断后胃肠吻合术治疗老年胃癌合并幽门梗阻的远期疗效[J].医学信息,2022,35(15):91.[doi:10.3969/j.issn.1006-1959.2022.15.020]
　SUN Chun-yang,Zhao Chang-hai.Long-term Efficacy of Total Laparoscopic Gastroenteric Anastomosis After Partial Gastrectomy in the Treatment of Elderly Gastric Cancer Complicated with Pyloric Obstruction[J].Journal of Medical Information,2022,35(02):91.[doi:10.3969/j.issn.1006-1959.2022.15.020]

更新日期/Last Update: 1900-01-01