摘要
目的:探讨3D腹腔镜在D2根治性全胃切除术中的优势及近期疗效。方法:回顾分析2017年2月至2018年2月由同一组医师完成的3D(n=14)与2D(n=18)腹腔镜胃癌D2根治性全胃切除术的临床资料。对比两组手术时间、淋巴结清扫数量、术中出血量等手术指标,及术后并发症、术后排气时间、术后住院时间等近期疗效指标。结果:两组患者一般资料差异无统计学意义(P>0.05);两组均顺利完成手术,无一例中转开腹。3D组与2D组手术时间[(271.0±45.2)min vs.(278.6±53.6)min,t=0.352,P=0.731]差异无统计学意义;但3D组术中出血更少[(105.4±31.3)mL vs.(142.2±58.6)mL,t=2.123,P=0.042];淋巴结清扫数量更多[(28.6±10.6)枚vs.(21.1±8.2)枚,t=2.278,P=0.030]。两组术后排气时间[(3.1±0.7)d vs.(3.7±1.0)d,t=1.928,P=0.063]、术后住院时间[(11.2±2.2)d vs.(12.3±2.2)d,t=1.115,P=0.278]、术后并发症发生率[21.4%(3/14) vs. 27.8%(5/18),P=1.000]差异无统计学意义。结论:与2D腹腔镜相比,3D腹腔镜D2根治性全胃切除术在术中出血量、淋巴结清扫数量方面优势明显,值得临床进一步推广。
Objective:To evaluate the advantages and short-term efficacy of three-dimensional(3 D) laparoscopic D2 radical total gastrectomy in adenocarcinoma of the esophagogastric junction.Methods:Retrospective analysis was made on the clinical data of 32 patients who underwent laparoscopic D2 radical total gastrectomy from Feb.2017 to Feb.2018.Among the 32 patients,14 received 3 D and 18 received two-dimensional(2 D) technique respectively.All the surgeries were performed by the same team.The operation time,the number of retrieved lymph nodes,intraoperative blood loss,incidence of postoperative complications,time to first flatus,postoperative hospital stay and other short-term parameters were compared between the two groups.Results:There was no significant difference between the two groups in baseline data(P>0.05),all patients were successfully completed the operation without conversion to laparotomy.Compared with 2 D group,3 D group had more retrieved lymph nodes [(28.6±10.6) vs.(21.1±8.2),t=2.273,P=0.030],less intraoperative blood loss [(105.4±31.3)mL vs.(142.2±58.6)mL,t=2.123,P=0.042].Whereas no significant differences were found between the two groups in operation time [(271.0±45.2)min vs.(278.6±53.6)min,t=0.352,P=0.731],time to first flatus [(3.1±0.7)d vs.(3.7±1.0)d,t=1.928,P=0.063],hospital stay [(11.2±2.2)d vs.(12.3±2.2)d,t=1.115,P=0.278] or incidence of postoperative complications [21.4%(3/14) vs. 27.8%(5/18),P=1.000].Conclusionss:Three-dimensional laparoscopic D2 radical total gastrectomy may be advantageous over two-dimensional laparoscopic D2 radical total gastrectomy in intraoperative blood loss and the number of retrieved lymph node,this procedure is worthy of further clinical promotion.
作者
谢杰斌
庞月珊
唐锦
花霞
魏寿江
李勋
XIE Jie-bin;PANG Yue-shan;TANG Jin(Department of Gastrointestinal Surgery,Affiliated Hospital of North Sichuan Medical College,Institute of Hepatobiliary and Pancreatic Diseases in North Sichuan Medical College,Nanchong 637000,China;Nanchong Central Hospital)
出处
《腹腔镜外科杂志》
2019年第7期498-501,共4页
Journal of Laparoscopic Surgery
基金
川北医学院科研发展计划重点资助课题(CBY15-A-ZD008)
关键词
胃肿瘤
胃癌D2根治术
腹腔镜检查
成像
三维
疗效比较研究
Stomach neoplasms
D2 radical gastrectomy
Laparoscopy
Imaging,three-dimensional
Comparative effectiveness research