3D全腹腔镜远端胃癌根治术的临床疗效

Clinical effect of totally three-dimensional laparoscopic radical gastrectomy of distal gastric cancer

目的探讨3D全腹腔镜远端胃癌根治术的临床疗效。方法回顾性分析2018年11月—2019年11月河南大学人民医院(河南省人民医院)胃肠外科行远端胃癌根治术的68例患者的临床资料。68例患者术前胃部肿瘤均经胃镜及病理学检查证实为恶性肿瘤,均按照日本胃癌协会第15版《胃癌处理规约》进行淋巴结清扫,严格遵循无瘤原则行标准D2根治术。观察指标包括:(1)手术情况。(2)术后情况。(3)随访情况。正态分布的计量资料以x±s表示。偏态分布的计量资料采用M(范围)表示。结果 68例患者均行3D全腹腔镜远端胃癌根治术。(1)手术情况:手术时间为(210±42)min,术中出血量为(107±35)mL;(2)术后情况:淋巴结清扫数目为(33±8)枚,术后肛门排气时间为(3.4±1.0)d,术后进半流食时间为(4.6±1.2)d,术后住院时间为(8.7±2.4)d,治疗费用为(8.2±1.4)万元。68例患者发生术后并发症4例,其中腹腔积液1例,经CT引导下置管穿刺引流后痊愈;1例吻合口漏,行空肠营养管置入及对症治疗后痊愈;1例切口感染,经控制感染,局部引流,加强换药后痊愈;1例肺部感染,经积极抗感染后痊愈。(3)随访情况:68例患者中,63例获得随访,随访时间为2~12个月,中位数8个月。随访期间无患者死亡,无患者出现肿瘤复发转移。结论 3D全腹腔镜远端胃癌根治术安全可行,临床效果显著。

Objective To explore the clinical effect of totally three-dimensional(3 D) laparoscopic radical gastrectomy of distal gastric cancer.Methods Using the method of retrospectively analysis. The clinical data of 68 patients with distal gastric cancer who underwent totally 3 D laparoscopic radical gastrectomy of distal gastric cancer in the People’s Hospital of Henan University from November 2018 to November 2019 were collected. The gastric tumour was diagnosed as the malignant tumor by the gastroscope before operation, The lymph node dissection and standard D2 radical surgery were performed according to the 15 th edition of Japanese General Rules for Cancer of Gastric of the Janpanese Gastric Cancer Association. Observation:(1)The surgical situtations.(2)Post-operative conditions.(3)Follow-up. Use mean number ± standard deviation represent the measurement data of normal distribution. Use M(range) represent the measurement data of skew distribution.Results All the 68 patients underwent 3 D laparoscopic radical resection of gastric cancer.(1)Surgical situations: the operation time of 68 patients was(210±42) min, the intraoperative blood loss was(107±35) mL;(2) Post-operative conditions: the postoperative number of lymph nodes dissection was was(33±8), the postoperative anal exhaust time was(3.4±1.0) d, the time to be able to swallow half-solid food was(4.6±1.2) days, the postoperative hospital stay was(8.7±2.4) days, and the treatment cost was(8.2±1.4) yuan.4 patients occurred the complications. One patient had ascites, one patient had anastomotic leakage,one patient had pulmonary infection, one patient had incision infection.(3) Follow-up:63 of 68 patients were followed up for 2 to 12 months, with a median follow-up of 8 months. No patient relapsed or died during the follow-up period.Conclusion The totally three-dimensional laparoscopic radical gastrectomy of distal gastric cancer is safe and feasible.