腹腔镜辅助根治性全胃切除术与近端胃切除术在贲门癌中应用的近期疗效对比

Contrast of short term effects of laparoscopic assisted total gastrectomy and proximal gastrectomy for cardiac carcinoma

目的腹腔镜辅助根治性全胃切除术与近端胃切除术治疗贲门癌的短期疗效比较。方法选择2015年1月到2016年2月在本院行腹腔镜贲门癌根治术的患者46例,其中根治性全胃切除术式组(全胃切除组)26例,根治性近端胃切除术式组(近端胃切除组)20例,比较两组术中情况、术后近期并发症、术后生活质量。结果两组手术时间、术中出血量、切口长度、首次排气时间、术后拔除引流管时间、术后住院时间、进流食时间、术后吻合口瘘、吻合口出血、吻合口狭窄、肠梗阻比较,差异均无统计学意义(均P>0.05);近端胃切除组患者的反流性食管炎发生率较全胃切除组高(P<0.05);全胃切除组患者在整体健康状况、情绪功能、呃逆等维度的生活质量评分优于近端胃切除组(均P<0.05)。结论对比腹腔镜近端胃切除术,腹腔镜根治性全胃切除术在治疗贲门癌中能够获得更好的近期生活质量。

Objective To compare the short term effects of laparoscopic assisted total gastrectomy and proximal gastrectomy for gastric cardia cancer. Methods From January 2015 to February 2016, 46 cases of gastric cardia cancer underwent laparoscopic radical resection in our hospital, including 26 cases of total gastrectomy （total gastrectomy group） and 20 cases of proximal gastrectomy （proximal gastrectomy group）. The intraoperative condition, postoperative complications and postoperative quality of life were compared between the two groups. Results The Operation time, intraoperative blood loss, length of incision, time to the first flatus, postoperative drainage time, postoperative hospitalization time, time to the first fluid diet, postoperative anastomotic fistula, anastomotic bleeding, anastomotic stenosis, intestinal obstruction of two groups were not statistical different （all P〉0.05 ）. Patients with proximal gastrectomy have higher incidence of reflux esophagitis. The quality of life score of overall health, emotional function, hiccup and other indicators in total gastrectomy group were significantly better than the proximal gastrectomy group. Conclusions Compared with laparoscopic proximal gastrectomy, laparoscopic radical total gastrectomy in the treatment of gastric cardin cancer can offer better quality of life in the near future.