胃癌根治术中吻合器与传统手工缝合的临床效果比较

Clinical effects of the stapler and the traditional manual suture on the radical gastrectomy of gastric cancer.

目的比较肠吻合器与传统手工缝合在胃癌经腹切除手术中的应用价值。方法选取2010年1月至2011年12月我院收治的胃癌患者56例,分别行吻合器经腹切口(n=30例)和传统经胸或胸腹手术(n=26例),观察两组手术效果、并发症及随访结果。结果吻合器组手术时间(67.3±13.3)min、胃肠功能恢复时间(51.3±5.6)h、住院时间(6.8±2.3)d、术中出血量(84.2±12.6)ml明显低于手工缝合组(P<0.05);术后并发症明显少于手工缝合组(P<0.05);局部转移率、远处转移率、1年复发率、2年复发率、1年生存率、2年生存率与手工缝合组比较差异无统计学意义(P>0.05)。结论吻合器经腹切除胃癌手术具有手术时间短、出血量低、恢复快、并发症少等优点,在条件许可的情况下,建议合理使用。

Objective To investigate the clinical effects of the stapler and the traditional manual suture on the radical resection of gastric cancer. Methods Fifty-six patients of gastric cancer were selected and carried out with stapled transabdominal radical gastrectomy （the stapler group, n=30） and the conventional transthoracic or thorac- ic and abdominal operation （the manual suture group, n=26）. The clinical effect, complications and follow-up results of two groups after operation were compared. Results The operation time of the stapler group was （67.3 ±13.3） rain, the gastrointestinal function recovery time was （51.3±5.6） h, the hospitalization time was （6.8±2.3） d and the amount of bleeding during the operation was （84.2±12.6） ml, all significantly lower than those of the manual suture group （P〈 0.05）. The postoperative complications of the stapler group were significantly less than those of the manual suture group （P〈0.05）, while the rate of local metastasis, distant metastasis, the 1-year, 2-year recurrence rate and the 1-year, 2-year survival rate showed no significant difference between the two groups （P〉0.05）. Conclusion The stapled transabdominal radical gastrectomy could shorten the operation time and reduce the bleeding volume, with recovery rapid and fewer complications, which should be recommended if conditions permit.