腹腔镜与开腹全胃切除术治疗Ⅰ期胃癌的近期效果及并发症发生情况比较

Comparison of short-term effect and occurrence of complications of laparoscopic and open total gastrectomy for stage Ⅰ gastric cancer

目的 比较腹腔镜与开腹全胃切除术治疗Ⅰ期胃癌的近期效果及并发症发生情况。方法 选取2018年6月至2021年2月收治的60例Ⅰ期胃癌患者为研究对象,根据手术方式不同将其分为参照组和研究组,各30例。参照组行开腹全胃切除术,研究组行腹腔镜全胃切除术。比较两组的治疗效果。结果 研究组的近期治疗总有效率高于参照组,差异具有统计学意义(P<0.05)。研究组的术后并发症总发生率低于参照组,差异具有统计学意义(P<0.05)。术后24 h,研究组的癌胚抗原(CEA)、糖类抗原19-9(CA19-9)水平低于参照组,差异具有统计学意义(P<0.05)。术后24 h,研究组的活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、凝血酶时间(TT)长于参照组,差异具有统计学意义(P<0.05)。术后24 h,研究组的白细胞分化抗原3阳性(CD3+)、白细胞分化抗原4阳性(CD4+)、白细胞分化抗原4阳性/白细胞分化抗原8阳性(CD4+/CD8+)高于参照组,白细胞分化抗原8阳性(CD8+)低于参照组,差异具有统计学意义(P<0.05)。结论相较于开腹全胃切除术,腹腔镜全胃切除术治疗Ⅰ期胃癌患者的近期效果更佳,并发症发生率更低。

Objective To compare the short-term effect and occurrence of complications of laparoscopic and open total gastrectomy for stageⅠgastric cancer.Methods A total of 60 patients with stageⅠgastric cancer admitted from June 2018 to February 2021 were selected as the research objects and divided into reference group and study group according to different surgical methods,with 30 cases in each group.The reference group underwent open total gastrectomy,and the study group underwent laparoscopic total gastrectomy.The therapeutic effects of the two groups were compared.Results The total effective rate of treatment in the near future of the study group was higher than that of the reference group,and the difference was statistically significant(P<0.05).The total incidence of postoperative complications in the study group was lower than that in the reference group,and the difference was statistically significant(P<0.05).At 24 h after operation,the levels of carcinoembryonic antigen(CEA),carbohydrate antigen 19-9(CA19-9)in the study group were lower than those in the reference group,and the differences were statistically significant(P<0.05).At 24 h after operation,the activated partial thromboplastin time(APTT),prothrombin time(PT),thrombin time(TT)in the study group were longer than those in the reference group,and the differences were statistically significant(P<0.05).At 24 h after operation,the cluster of differentiation 3 positive(CD3+),cluster of differentiation 4 positive(CD4+),cluster of differentiation 4 positive/cluster of differentiation 8 positive(CD4+/CD8+)in the study group were higher than those in the reference group,the cluster of differentiation 8 positive(CD8+)was lower than that of the reference group,and the differences were statistically significant(P<0.05).Conclusion Compared with open total gastrectomy,laparoscopic total gastrectomy has better short-term effect and lower incidence of complications in patients with stageⅠgastric cancer.