腹腔镜胃癌根治术中行血管导向淋巴清扫的临床价值研究

Clinical Value of Vascular-guided Lymph Node Dissection in Laparoscopic Radical Gastrectomyfor Gastric Cancer

目的探究腹腔镜胃癌根治术中行血管导向淋巴清扫的临床应用效果。方法回顾性分析2018年3月至2020年9月我院收治的88例行腹腔镜胃癌根治术患者临床资料,其中采用常规淋巴结清扫术的48例患者纳入对照组,另行血管导向淋巴结清扫的40例患者纳入观察组。对比两组围术期指标、血清因子[基质金属蛋白酶-9(MMP-9)、血管内皮生长因子(VEGF)和人组织激肽释放酶7(KLK7)]及并发症发生情况。结果观察组患者手术时间短于对照组,术中出血量少于对照组,淋巴结清扫数目多于对照组,MMP-9、VEGF、KLK7水平均高于对照组,差异有统计学意义(P<0.05)。观察组并发症发生率显著低于对照组,差异有统计学意义(P<0.05)。结论腹腔镜胃癌根治术中行血管导向淋巴清扫,能够增强淋巴结清扫效果,且手术时间更短,术中出血量较少,术后并发症发生率更低,值得推广。

Objectives To investigate the clinical effect of vascular-guided lymph node dissection in laparoscopic radical gastrectomyfor gastric cancer.Methods A retrospective analysis was performed on 88 patients who underwent laparoscopic radical gastrectomyfor gastric cancer in our hospital from March 2018 to September 2020.Among them,48 patients who underwent conventional lymph node dissection were included in the control group,and 40 patients who underwent vascular-guided lymph node dissection were included in the observation group.The perioperative indexes,serum factors[matrix metalloproteinase-9(MMP-9),vascular endothelial growth factor(VEGF)and human tissue kallikrein 7(KLK7)]and complications were compared between the two groups.ResultsThe operation time of the observation group was shorter than that of the control group,the intraoperative blood loss was less than that of the control group,the number of lymph node dissection was more than that of the control group,and the levels of MMP-9,VEGF and KLK7 were higher than those of the control group,the differences are statistically significant(P<0.05).The incidence of complications in the observation group was significantly higher than that in the control group(P<0.05).Conclusions Vascular-guided lymph node dissection in laparoscopic radical gastrectomy for gastric cancer can enhance the effect of lymph node dissection,and the operation time is shorter,the amount of intraoperative bleeding is less,the incidence of postoperative complications is lower,which is worth promoting.