全胃切除术与近端胃切除术在弥漫型近端进展期胃癌患者中的应用效果比较

Comparison of the Application Effects of Total Gastrectomy and Proximal Gastrectomy in Patients with Diffuse Proximal Advanced Gastric Cancer

目的对比全胃切除术与近端胃切除术在弥漫型近端进展期胃癌患者中的应用效果。方法选取该院2022年1月-2023年1月收治的90例弥漫型近端进展期胃癌患者为研究对象,以随机法将其分为观察组和对照组,每组45例。对照组采用腹腔镜近端胃切除术,观察组采用腹腔镜全胃切除术。对比两组围术期情况、生化指标、并发症发生率和满意度。结果观察组手术时间(265.21±12.27)min、肛门排气时间(3.17±0.35)d均长于对照组的(256.76±14.28)min、(2.91±0.32)d,组间差异有统计学意义(P<0.05)。两组术中出血量、住院天数比较,组间差异无统计学意义(P>0.05)。术后24 h,观察组血红蛋白(10.18±0.97)g/L、总蛋白(11.13±1.23)g/L水平均低于对照组的(14.34±1.13)g/L、(14.37±1.45)g/L,组间差异有统计学意义(P<0.05)。观察组并发症发生率2.22%低于对照组的17.78%,差异有统计学意义(P<0.05)。观察组满意度97.78%高于对照组的80.00%,差异有统计学意义(P<0.05)。结论与腹腔镜近端胃切除术对比,腹腔镜全胃切除术应用在弥漫型近端进展期胃癌患者中对围术期情况影响不大,并发症发生率低,可提高手术满意度,值得临床应用。

Objective To compare the application effects of total gastrectomy and proximal gastrectomy in patients with diffuse proximal advanced gastric cancer.Methods 90 patients with diffuse proximal advanced gastric cancer in our hospital from January 2022 to January 2023 were selected as the research objects and they were randomly divided into an observation group and a control group,with 45 patients in each group.The control group underwent laparoscopic proximal gastrectomy,while the observation group underwent laparoscopic total gastrectomy.Compare the perioperative conditions,biochemical indicators,incidence of complications,and satisfaction between two groups.Results The surgical time(265.21±12.27)min and anal exhaust time(3.17±0.35)d of the observation group were longer than(256.76±14.28)min,(2.91±0.32)d of the control group,and the differences between groups were statistically significant(P<0.05).There was no statistically significant difference in intraoperative bleeding and hospital stay(P>0.05).24 hours after surgery,the levels of of hemoglobin(10.18±0.97)g/L and total protein(11.13±1.23)g/L in the observation group were lower than(14.34±1.13)g/L and(14.37±1.45)g/L in the control group,with statistical significance(P<0.05).The incidence of complications in the observation group was 2.22%,lower than 17.78%in the control group,and the difference was statistically significant(P<0.05).The satisfaction rate of the observation group was 97.78%,higher than 80.00%in the control group,and the difference was statistically significant(P<0.05).Conclusion Compared with laparoscopic proximal gastrectomy,laparoscopic total gastrectomy has little effect on perioperative conditions in patients with diffuse proximal advanced gastric cancer,with low complication rate and improved surgical satisfaction,which is worthy of clinical application.