3D-CT描述胃周血管腹腔干变异在腹腔镜下胃癌根治术中的作用

Effect of 3D-CT description of perigastric vascular celiac trunk variation on laparoscopic surgery in patients with gastric cancer

目的分析3D-CT描述胃周血管腹腔干变异对腹腔镜下胃癌根治术的作用。方法回顾性分析2019年1月-2021年1月该院收治的185例胃癌患者的临床资料,均采用3D-CT描述胃周血管腹腔干变异情况,依据腹腔干情况分为观察组(腹腔干常见型,n=159)和对照组(腹腔干罕见型,n=26),两组均采用腹腔镜下胃癌根治术治疗。比较两组患者的围术期指标、手术前后炎性反应情况和不良反应。结果观察组平均出血量、手术时间和首次排气时间均少于对照组;手术后两组患者的血清白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、高敏C反应蛋白(hs-CRP)、去甲肾上腺素(NA)、促肾上腺皮质激素(ACTH)水平明显高于术前,但观察组少于对照组,差异均有统计学意义(P<0.05)。结论胃癌患者腹腔镜手术前经3D-CT描述胃周血管腹腔干变异情况,能够在一定程度上减少术中出血量、缩短手术时间、促进术后排气、缓解围术期炎性反应,安全性较佳。

Objective To analyze the effect of 3D-CT describe the perigastric vascular and abdominal cavity variation of laparoscopic radical gastric cancer surgery.Methods The clinical data of 185 patients with gastric cancer treated in our hospital from January 2019 to January 2021 analyzed retrospectively.3D-CT was used to describe the variation of gastric vascular and abdominal cavity.According to the condition of abdominal cavity,they were divided into observation group(common type of abdominal cavity,n=159)and the control group(rare celiac trunk,n=26),both groups were treated with laparoscopic radical gastrectomy.The perioperative indicators,inflammatory reactions and adverse reactions before and after the operation were compared between the two groups.Results The average blood loss,operation time and first exhaust time of the observation group were less than those of the control group;the serum IL-6,TNF-α,hs-CRP,NA,and ACTH levels of the observation group and the control group after the operation were higher than that before operation,but the observation group was less than that in the control group,the difference was statistically significant(P<0.05).Conclusion Gastric cancer patients described by 3D-CT before laparoscopic surgery can reduce the amount of intraoperative blood loss to a certain extent,shorten the operation time,promote postoperative exhaust,relieve perioperative inflammatory reactions,and be better safty.