[1]贾泽斌,蒋浩海.腹腔镜辅助胃癌根治术治疗进展期胃癌的临床疗效及近期预后观察[J].医学信息,2022,35(20):45-48.[doi:10.3969/j.issn.1006-1959.2022.20.010]
　JIA Ze-bin,JIANG Hao-hai.Clinical Efficacy and Short-term Prognosis of Laparoscopic-assisted Radical Gastrectomy for Advanced Gastric Cancer[J].Journal of Medical Information,2022,35(20):45-48.[doi:10.3969/j.issn.1006-1959.2022.20.010]
点击复制

腹腔镜辅助胃癌根治术治疗进展期胃癌的临床疗效及近期预后观察()
分享到：

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
35卷
期数:
2022年20期
页码:
45-48
栏目:
论著
出版日期:
2022-10-15

文章信息/Info

Title:
Clinical Efficacy and Short-term Prognosis of Laparoscopic-assisted Radical Gastrectomy for Advanced Gastric Cancer
文章编号:
1006-1959（2022）20-0045-04
作者:
贾泽斌; 蒋浩海
（盐城市第一人民医院普外科，江苏 盐城 224000）
Author(s):
JIA Ze-bin; JIANG Hao-hai
(Department of General Surgery,Yancheng No.1 People’s Hospital,Yancheng 224000,Jiangsu,China)
关键词:
进展期胃癌; 胃癌根治术; 腹腔镜; 微转移; 生存质量; 淋巴结清扫
Keywords:
Advanced gastric cancer; Radical gastrectomy; Laparoscopy; Microtransfer; Quality of life; Lymph node dissection
分类号:
R735.2
DOI:
10.3969/j.issn.1006-1959.2022.20.010
文献标志码:
A
摘要:
目的 研究腹腔镜辅助胃癌根治术治疗进展期胃癌的临床疗效及近期预后。方法 选取2020年2月-2021年2月于盐城市第一人民医院收治的66例进展期胃癌患者，按照随机数字表法分为对照组（33例）与观察组（33例）。对照组行开腹胃癌根治术治疗，观察组行腹腔镜辅助胃癌根治术治疗，比较两组临床疗效、围术期指标、并发症发生率、微转移指标[腹腔冲洗液癌胚抗原（CEA）、多巴胺脱羧酶（DDC）]、近期预后情况[转移、复发、胃癌患者生活质量问卷（QLQ-ST022）评分]。结果 观察组手术清扫淋巴结总数、远切端距肿瘤距离、近切端距肿瘤距离与对照组比较，差异无统计学意义（P＞0.05）；观察组手术时间、术后肛门排气时间、首次下床活动时间、术后住院时间均短于对照组，且术中出血量少于对照组（P＜0.05）；观察组并发症发生率低于对照组（P＜0.05）；观察组术后CEA、DDC水平低于对照组（P＜0.05）；术后6个月，两组转移、复发情况比较，差异无统计学意义（P＞0.05），但观察组QLQ-ST022评分低于对照组（P＜0.05）。结论 腹腔镜辅助胃癌根治术治疗进展期胃癌的疗效确切，可在保证淋巴清扫效果的基础上，缩短手术及术后恢复时间，减少术中出血，降低并发症及潜在腹腔微转移风险，改善患者近期预后质量。
Abstract:
Objective To study the clinical efficacy and short-term prognosis of laparoscopic assisted radical gastrectomy for advanced gastric cancer. Methods A total of 66 patients with advanced gastric cancer admitted to Yancheng No.1 People’s Hospital from February 2020 to February 2021 were selected and divided into control group (33 cases) and observation group (33 cases) according to random number table method. The control group was treated with open radical gastrectomy for gastric cancer, and the observation group was treated with laparoscopic assisted radical gastrectomy for gastric cancer. The clinical efficacy, perioperative indicators, incidence of complications, micrometastasis indicators [carcinoembryonic antigen (CEA), dopamine decarboxylase (DDC)], short-term prognosis [metastasis, recurrence, Quality of Life Questionnaire of Stomach 22 (QLQ-ST022) score] were compared between the two groups.Results There was no significant difference in the total number of lymph nodes dissected, the distance from the distal cut end to the tumor, and the distance from the proximal cut end to the tumor between the observation group and the control group (P>0.05). The operation time, postoperative anal exhaust time, first ambulation time and postoperative hospital stay in the observation group were shorter than those in the control group, and the intraoperative blood loss was less than that in the control group (P<0.05). The incidence of complications in the observation group was lower than that in the control group (P<0.05). The levels of CEA and DDC in the observation group were lower than those in the control group (P<0.05). At 6 months after operation, there was no significant difference in metastasis and recurrence between the two groups (P>0.05), but the QLQ-ST022 score of the observation group was lower than that of the control group (P<0.05).Conclusion Laparoscopic assisted radical gastrectomy is effective in the treatment of advanced gastric cancer. On the basis of ensuring the effect of lymph node dissection, it can shorten the operation and postoperative recovery time, reduce intraoperative bleeding, reduce complications and potential risk of abdominal micrometastasis, and improve the quality of short-term prognosis of patients.

参考文献/References:

[1]刘俊英,刘腾,王超,等.腹腔镜辅助与开腹D2胃癌根治术对进展期胃癌治疗效果的前瞻性研究[J].腹腔镜外科杂志,2021,26(3):200-205.[2]王智浩,李毅,牛兆建,等.全腹腔镜远端胃癌根治术治疗局部进展期胃癌的近期疗效分析[J].腹腔镜外科杂志,2020,25(11):804-808.[3]李建.腹腔镜辅助小切口胃癌根治术治疗进展期胃癌疗效及安全性研究[J].中国数字医学,2017,12(1):64-66.[4]钱晨,杨丰,徐英杰,等.腹腔镜与开腹胃癌根治术对进展期胃癌患者机体应激反应和细胞免疫功能的影响[J].上海医学,2019,42(5):263-268.[5]杨海棠,杨凯歌,杨磊.腹腔镜辅助D2式胃癌根治术治疗老年进展期胃癌临床观察[J].中华实用诊断与治疗杂志,2019,33(5):478-479.[6]戴春,谭明,耿兴荣,等.腹腔镜辅助小切口胃癌根治术在进展期胃癌患者的应用[J].江苏医药,2019,45(2):203-205.[7]Min JS,Jeong SH,Park JH,et al.A comparison of quality of life between patients with small and large gastric remnant volumes after gastrectomy for gastric cancer[J].Medicine (Baltimore),2021,100(33):e26954.[8]Jongerius EJ,Boerma D,Seldenrijk KA,et al.Role of omentectomy as part of radical surgery for gastric cancer[J].Br J Surg,2016,103(11):1497-1503.[9]杜广胜,邱远,王文生,等.腹腔镜辅助与开腹胃癌根治术治疗进展期胃癌的效果对比观察[J].中外医学研究,2018,16(12):12-15.[10]赵刚,武青生,穆元忠,等.腹腔镜辅助下D2根治术对进展期远端胃癌患者临床疗效、术后并发症及住院时间的影响[J].癌症进展,2017,15(11):1335-1337,1341.[11]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.[12]宋业,李志超,侯建彬,等.腹腔镜下胃癌根治术对老年患者胃肠功能、凝血功能的影响[J].癌症进展,2021,19(15):1593-1596.[13]李敏哲,沈荐,杜燕夫,等.进展期胃癌腹腔镜辅助与开腹全胃D2根治术临床疗效的比较[J].中国微创外科杂志,2017,17(7):589-593.[14]黄景山,苏昭然,王贵和.腹腔镜辅助D2根治术与开腹手术治疗进展期胃癌的疗效对比研究[J].安徽医学,2017,38(6):709-712.[15]江永强,曹辉,姜宝,等.腹腔镜辅助胃癌根治术应用于进展期胃癌的疗效分析[J].中国普外基础与临床杂志,2019,26(9):1087-1092.[16]崔军,司磊.完全腹腔镜与腹腔镜辅助进展期远端胃癌根治术的近期疗效比较[J].中国现代普通外科进展,2017,20(1):38-40.[17]丁德胜.腹腔镜辅助下远端胃癌D2根治术治疗进展期胃癌的疗效分析[J].中华全科医学,2016,14(8):1325-1326,1350.[18]张英杰,梁金荣.腹腔镜胃癌根治术治疗进展期胃癌患者的近期疗效及对腹腔内微转移的影响[J].中华全科医学,2017,15(11):1867-1869,1890.[19]王进,郭绍春,樊林,等.进展期胃癌腹腔镜辅助与开放D2根治术围手术期临床效果比较[J].现代肿瘤医学,2016,24(7):1080-1082.[20]仝德峰,刘江文,孙琳,等.进展期胃癌腹腔镜辅助D2根治术的临床疗效分析[J].中国普通外科杂志,2015,24(8):1201-1204.[21]Gao YS,Sun JG,Huang JJ,et al.Gao’s double-way approach for laparoscopic D2 radical surgery for gastric cancer[J].World J Gastrointest Surg,2016,8(6):424-426.[22]韦炳邓,罗中,关秀文,等.腹腔镜辅助与开腹远端胃癌根治术治疗进展期胃癌的疗效比较[J].南昌大学学报(医学版),2015,55(1):44-47.[23]汤兴华,刘雄,章宜兰,等.腹腔镜辅助下远端胃癌D2根治术治疗进展期胃癌的疗效及安全性[J].中国肿瘤临床与康复,2015,22(6):656-658.[24]肖毅频,熊璐琪,钟晓华,等.腹腔镜胃癌根治术对进展期胃癌患者腹腔冲洗液CEA、DDC浓度及炎性因子影响研究[J].临床和实验医学杂志,2018,17(9):986-990.[25]Zhang F,Lan Y,Tang B,et al.Comparative study of laparoscopy-assisted and open radical gastrectomy for stage T4a gastric cancer[J].Int J Surg,2017,41:23-27.

相似文献/References:

[1]张林.围术期输血对胃癌根治术患者预后及免疫的影响[J].医学信息,2018,31(01):94.[doi:10.3969/j.issn.1006-1959.2018.01.033]
　ZHANG Lin.Effect of Perioperative Blood Transfusion on Prognosis and Immunity of Patients with Radical Gastrectomy[J].Journal of Medical Information,2018,31(20):94.[doi:10.3969/j.issn.1006-1959.2018.01.033]
[2]饶 瑾,宗志军,高之心,等.超声引导双侧胸椎旁神经阻滞用于开放性 胃癌根治术患者的镇痛效果观察[J].医学信息,2018,31(11):80.[doi:10.3969/j.issn.1006-1959.2018.11.025]
　RAO Jin,ZONG Zhi-jun,GAO Zhi-xin,et al.Observation on Analgesic Effect of Bilateral Thoracic Paravertebral Nerve Block Guided by Ultrasound in Patients Undergoing Open Radical Gastrectomy for Gastric Cancer[J].Journal of Medical Information,2018,31(20):80.[doi:10.3969/j.issn.1006-1959.2018.11.025]
[3]肖宝强,张 霆,孙新增,等.腹腔镜与开腹根治术对进展期胃癌患者的近期疗效、 应激水平、免疫功能影响的差异性研究[J].医学信息,2018,31(14):75.[doi:10.3969/j.issn.1006-1959.2018.14.022]
　XIAO Bao-qiang,ZHANG Ting,SUN Xin-zeng,et al.Differences between Laparoscopic and Open Radical Resection for Short-term Efficacy, Stress Level and Immune Function in Patients with Advanced Gastric Cancer[J].Journal of Medical Information,2018,31(20):75.[doi:10.3969/j.issn.1006-1959.2018.14.022]
[4]白 茹,陈永侠,王 莉.心理护理对胃癌根治术后患者免疫功能的影响[J].医学信息,2018,31(20):170.[doi:10.3969/j.issn.1006-1959.2018.20.054]
　BAI Ru,CHEN Yong-xia,WANG Li.Effect of Psychological Nursing on Immune Function of Patients with Gastric Carcinoma after Radical Operation[J].Journal of Medical Information,2018,31(20):170.[doi:10.3969/j.issn.1006-1959.2018.20.054]
[5]王绥能,梁贤文,孙 光,等.伊立替康新辅助化疗在进展期胃癌的临床意义[J].医学信息,2018,31(24):164.[doi:10.3969/j.issn.1006-1959.2018.24.050]
　WANG Sui-neng,LIANG Xian-wen,SUN Guang,et al.Clinical Significance of Irinotecan Neoadjuvant Chemotherapy in Advanced Gastric Carcinoma[J].Journal of Medical Information,2018,31(20):164.[doi:10.3969/j.issn.1006-1959.2018.24.050]
[6]张子龙,魏雯欣,李汝泓,等.超声引导下ESPB联合PCIA与单纯PCIA对胃癌根治术患者术后镇痛效果的比较[J].医学信息,2018,31(20):61.[doi:10.3969/j.issn.1006-1959.2018.20.018]
　ZHANG Zi-long,WEI Wen-xin,LI Ru-hong,et al.Comparison of Postoperative Analgesic Effects of ESPB Combined with PCIA and PCIA Alone in Patients with Radical Resection of Gastric Cancer under Ultrasound Guidance[J].Journal of Medical Information,2018,31(20):61.[doi:10.3969/j.issn.1006-1959.2018.20.018]
[7]刘 刚,吴晓阳.胃癌根治术后继发急性小肠扭转临床分析[J].医学信息,2020,33(18):188.[doi:10.3969/j.issn.1006-1959.2020.18.064]
　LIU Gang,WU Xiao-yang.Clinical Analysis of Acute Small Bowel Volvulus after Radical Gastric Cancer[J].Journal of Medical Information,2020,33(20):188.[doi:10.3969/j.issn.1006-1959.2020.18.064]
[8]李 雄,田宏伟,苗长丰,等.胃癌根治术后发生胃瘫综合征危险因素的系统评价与Meta分析[J].医学信息,2022,35(24):87.[doi:10.3969/j.issn.1006-1959.2022.24.017]
　LI Xiong,TIAN Hong-wei,MIAO Chang-feng,et al.Systematic Review and Meta-analysis of Risk Factors for Gastroparesis Syndrome After Radical Gastrectomy For Gastric Cancer[J].Journal of Medical Information,2022,35(20):87.[doi:10.3969/j.issn.1006-1959.2022.24.017]
[9]方兴中,杨建美,许晓燕,等.加速康复外科策略在胃癌根治术围手术期中的应用价值[J].医学信息,2021,34(09):92.[doi:10.3969/j.issn.1006-1959.2021.09.024]
　FANG Xing-zhong,YANG Jian-mei,XU Xiao-yan,et al.Application Value of Accelerated Rehabilitation Surgery Strategy in the Perioperative Period of Radical Gastric Cancer Surgery[J].Journal of Medical Information,2021,34(20):92.[doi:10.3969/j.issn.1006-1959.2021.09.024]
[10]汪 舸,王胜斌,居 霞,等.利多卡因复合右美托咪定对胃癌根治联合术中腹腔热灌注化疗患者的影响[J].医学信息,2021,34(10):83.[doi:10.3969/j.issn.1006-1959.2021.10.023]
　WANG Ge,WANG Sheng-bin,JU Xia,et al.The Effect of Lidocaine Combined with Dexmedetomidine on Patients with Radical Gastric Cancer Combined with Hyperthermic Intraperitoneal Chemotherapy[J].Journal of Medical Information,2021,34(20):83.[doi:10.3969/j.issn.1006-1959.2021.10.023]

更新日期/Last Update: 1900-01-01