基于D2胃切除术的系统性胃系膜切除术对进展期胃癌患者的疗效分析

Analysis of Therapeutic Effect of Systematic Mesogastrectomy Based on D2 Gastrectomy in Patients with Advanced Gastric Cancer

目的探讨基于D2胃切除术的系统性胃系膜切除术在进展期胃癌(AGC)中的效果。方法选取72例AGC患者,按随机数字表法划分成两组,各36例。对照组给予腹腔镜辅助胃癌D2根治术,观察组施行腹腔镜辅助胃癌D2根治术+系统性胃系膜切除术,观察到术后3个月。对比两组手术相关指标、术中不良事件发生情况、术后恢复情况、生活质量、并发症。结果两组淋巴结清扫数目相比,无统计学差异(P>0.05);观察组术中出血量少于对照组,手术、首次进食、肛门排气以及住院时间均短于对照组,术中不良事件与并发症发生率低于对照组,有统计学差异(P<0.05);术前,两组生活质量综合评定问卷(GQOLI-74)内各维度评分相比,无统计学差异(P>0.05);术后3个月,观察组GQOLI-74内各维度评分均高于对照组,有统计学差异(P<0.05)。结论基于D2胃切除术的系统性胃系膜切除术在AGC患者治疗中效果更加,具有出血量更少、手术时间更短等特点,并可明显减少手术过程中不良事件产生的风险,以此使得患者术后可迅速恢复,进而改善生活质量,且并发症少,值得临床的大力推行。

Objective To investigate the effect of D2 Gastrectomy based systematic mesogastrectomy in advanced gastric cancer(AGC).Methods 72 AGC patients were selected and divided into 2 groups using a random number table method,with 36 patients in each group.The control group received laparoscopic assisted D2 radical gastrectomy for gastric cancer,while the observation group received laparoscopic assisted D2 radical gastrectomy+systematic mesogastrectomy.The postoperative period was 3 months.Compared the 2 groups of surgical related indicators,incidence of intraoperative adverse events,postoperative recovery,quality of life,and complications.Results There was no statistically significant difference in the number of lymph node dissection between the 2 groups(P>0.05);The observation group had less intraoperative bleeding than the control group,and had shorter surgery,first meal,anal exhaust,and hospital stay than the control group.The incidence of adverse events and complications during surgery was lower than the control group,with a statistical difference(P<0.05);Before surgery,there was no statistically significant difference(P>0.05)in the scores of each dimension between the 2 groups in the Comprehensive Quality of Life Assessment Questionnaire(GQOLI-74);Three months after surgery,the GQOLI-74 scores in all dimensions in the observation group were higher than those in the control group,with statistical differences(P<0.05).Conclusion The systematic mesogastrectomy based on D2 Gastrectomy is more effective in the treatment of AGC patients,with less bleeding,shorter operation time and other characteristics,and can significantly reduce the risk of adverse events during the operation,so that patients can recover quickly after surgery,improve their quality of life,and have fewer complications,which is worth vigorously promoting in clinical practice.