右侧前入路与左侧后入路腹腔镜远端胃癌根治术治疗胃癌患者的效果比较

Comparison of effects of distal radical gastrectomy through right anterior approach and left posterior approach in treatment of patients with gastric cancer

目的:比较右侧前入路与左侧后入路腹腔镜远端胃癌根治术治疗胃癌患者的效果。方法:选取80例胃癌患者为研究对象,按照随机数字表法分为对照组和观察组各40例。两组均采取腹腔镜远端胃癌根治术治疗,观察组采取右侧前入路,对照组采取左侧后入路。比较两组手术相关指标水平、术后恢复相关指标水平、炎性因子[超敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)]水平以及并发症发生率。结果:观察组手术时间短于对照组,术中出血量少于对照组,淋巴结清扫数目多于对照组,差异均有统计学意义(P<0.05);观察组术后下床活动时间短于对照组,差异有统计学意义(P<0.05);两组拔除胃管时间、排气恢复时间、住院时间比较,差异均无统计学意义(P>0.05);术后,两组hs-CRP、IL-6水平均高于术前,但观察组低于对照组,差异有统计学意义(P<0.05);观察组并发症发生率为17.50%,与对照组的5.00%比较,差异无统计学意义(P>0.05)。结论:前入路腹腔镜远端胃癌根治术治疗胃癌患者可缩短手术时间和术后下床活动时间,减少术中出血量,提高淋巴结清扫数目,以及降低炎性因子水平,优于后入路腹腔镜远端胃癌根治术治疗效果。

Objective:To compare effects of distal radical gastrectomy through right anterior approach and left posterior approach in treatment of patients with gastric cancer.Methods:80 patients with gastric cancer were selected as the research objects and were divided into control group and observation group according to the random number table method,40 cases in each group.Both groups were treated with laparoscopic distal radical gastrectomy.The observation group was given the right anterior approach,while the control group used the left posterior approach.The levels of surgery-related indexes,the postoperative recovery-related indexes,the inflammatory factor indexes[high-sensitivity C-reactive protein(hs-CRP),interleukin-6(IL-6)]and the incidence of complications were compared between the two groups.Results:The operation time of the observation group was shorter than that of the control group;the intraoperative blood loss was lower than that of the control group;the getting out of bed time in the observation group after the surgery was shorter than that in the control group;and the differences were statistically significant(P<0.05).However,there were no significant differences between the two groups in the removal of gastric tube,the recovery of exhaust gas,and the hospitalization time(P>0.05).After the surgery,the levels of hs-CRP and IL-6 in the two groups were higher than those before the surgery;those of the observation group were lower than those of the control group;and the differences were statistically significant(P<0.05).Further,the incidence of complications in the observation group was 17.50%,compared with 5.00%in the control group,the difference was not statistically significant(P>0.05).Conclusions:Distal radical gastrectomy through the anterior approach can shorten the operation time and the postoperative getting out of bed time,reduce the intraoperative blood loss,increase the number of lymph nodes dissected,and reduce the levels of inflammatory factors.Moreover,it is superior to distal radical gastrectomy through the posterior approach.