96例手辅助腹腔镜胃癌根治性全胃切除术临床分析

Clinical analysis of 96 cases of hand-assisted laparoscopic radical total gastrectomy for gastric

目的探讨手辅助腹腔镜胃癌根治性全胃切除术的临床疗效。方法回顾性分析2012年5月至2016年5月行手辅助下腹腔镜胃癌根治术96例患者(手辅助组)临床资料,另选择同期行腹腔镜胃癌根治术患者100例为传统组,采用SPSS20软件包分析,术中术后指标均采用均数±标准差(x珋±s)进行描述,两组间比较采用t检验;并发症率发生率组间比较采用χ2检验;P<0.05差异具有统计学意义。结果手辅助组手术时间显著少于传统组(t=22.012,P<0.05),术中出血量、淋巴结清扫数量、淋巴结阳性数量、术后胃肠道功能恢复时间、术后进流食时间、术后开始下床活动时间、术后尿管留置天数、术后住院天数,两组相比差异均无统计学意义,P>0.05;两组患者术后并发症情况,手辅助组发生率为10.2%,传统组发生率为8.0%,差异无统计学意义,P>0.05。结论使用手辅助腹腔镜性胃癌根治性全胃切除术,可以减短手术时间,在手术效果和术后并发症上与传统腹腔镜手术无异,值得临床广泛推广使用。

Objective To explore the clinical value of total gastrectomy for hand-assisted laparoscopic radical gastrectomy. Methods 96 cases of hand-assisted laparoscopic radical total gastrectomy and100 cases of total laparoscopic radical total gastrectomy（traditional group） treated in our hospital from May2012 to May 2016 were compared. In the traditional group,SPSS20 software package was used to analyze the postoperative data. The mean values were（x珋± s）,and the t test was used between the two groups. The incidence of complication rate was compared with χ^2test. P〈0. 05 meaned the differences were statistically significant. Results The operation time of hand-assisted group was significantly lower than that of the traditional group,t = 22. 012,P〈0. 05,There were no significant differences in the volume of intraoperative blood loss,the number of lymph node dissection,the positive number of lymph nodes,the recovery time of gastrointestinal function,the number of days after hospitalization,the number of days of catheter retention,and the number of days after hospitalization.（P〉0. 05）. The incidence of postoperative complications and hand-assisted group was 10. 2 %,The incidence of traditional group was 8. 0%,the difference was not statistically significant,P〉0. 05. Conclusion The use of hand-assisted laparoscopic radical gastrectomy for total gastrectomy can shorten the operation time. The surgical effect and postoperative complications are similar to those of traditional laparoscopic surgery. It is worthy to be widely used in clinical practice.