网膜囊切除在全腹腔镜胃癌根治术治疗进展期胃癌中的应用效果

Application effect of omental sac resection in total laparoscopic radical gastrectomy on advanced gastric cancer

目的分析网膜囊切除在全腹腔镜胃癌根治术治疗进展期胃癌中的应用效果。方法回顾性分析2017年3月至2019年4月我院收治的57例进展期胃癌患者的临床资料,所有患者均采用了全腹腔镜胃癌根治术联合D2淋巴结清扫术,根据治疗方法的不同将其分为对照组(n=30,未切除网膜囊治疗)和观察组(n=27,同步切除网膜囊治疗)。比较两组的治疗效果。结果观察组的手术时间长于对照组,但术中出血量、切口长度、术后首次通气时间、拔除引流管时间、术后住院时间及术后胃肠功能恢复时间均优于对照组(P<0.05)。观察组的感染(腹腔/切口/肺部/尿路)发生率明显低于对照组(P<0.05)。术后6个月、1年,观察组的生活质量评分明显低于对照组,差异具有统计学意义(P<0.05)。结论全腹腔镜胃癌根治术中加行网膜囊切除治疗进展期胃癌可明显提高患者的生存质量,促进其早期康复,且安全性较高。

Objective To analyze the application effect of omental sac resection in total laparoscopic radical gastrectomy on advanced gastric cancer.Methods The clinical data of 57 patients with advanced gastric cancer admitted in our hospital from March 2017 to April 2019 were retrospectively analyzed.All patients received total laparoscopic radical gastrectomy combined with D2 lymphadenectomy.According to the different treatment methods,the patients were divided into control group(n=30,omental sac was not resected)and observation group(n=27,omental sac was resected simultaneously).The therapeutic effects of the two groups were compared.Results The operation time of the observation group was longer than that of the control group,but the amount of intraoperative blood loss,incision length,postoperative first ventilation time,drainage tube removal time,postoperative hospital stay and postoperative gastrointestinal function recovery time were better than those of the control group(P<0.05).The incidence of infection(abdominal cavity/incision/lung/urinary tract)of observation group was significantly lower than that of the control group(P<0.05).At 6 months and 1 year after operation,the quality of life scores of the observation group were significantly lower than those of the control group,and the differences were statistically significant(P<0.05).Conclusion Total laparoscopic radical gastrectomy combined with omental sac resection in the treatment of advanced gastric cancer can significantly improve the quality of life,promote the early recovery of patients,with high safety.