腹腔镜下膜解剖胃癌D2联合CME根治术治疗胃癌的疗效

Efficacy of Laparoscopic Membranous Dissection of Gastric Cancer D2 Combined with Radical CME in the Treatment of Gastric Cancer

目的 探讨腹腔镜下膜解剖胃癌D2联合胃背侧系膜近胃端完整系膜切除术(complete mesoeolic excision,CME)治疗胃癌的并发症及预后观察。方法 随机选取2019年1月—2022年1月泉州市第一医院收治的100例胃癌患者为研究对象,采用随机数表法分成对照组(50例)、观察组(50例)。对照组给予腹腔镜下D2根治术治疗,观察组给予腹腔镜下D2联合CME根治术治疗,比较两组手术及术后恢复相关指标、并发症发生和预后情况。结果 观察组淋巴结清扫数目多于对照组,术中出血量少于对照组,手术时间短于对照组,差异有统计学意义(P均<0.05)。观察组首次排气、下床活动、恢复普食和住院所用时长均短于对照组,差异有统计学意义(P均<0.05)。观察组并发症发生率(4.00%)低于对照组(16.00%),差异有统计学意义(χ^(2)=4.000,P<0.05)。观察组1年肿瘤转移率(12.00)。低于对照组(30.00%),差异有统计学意义(P<0.05)。观察组1年生存率(90.00%)高于对照组(74.00%),差异有统计学意义(P<0.05)。结论 通过腹腔镜下膜解剖胃癌D2联合CME根治术治疗胃癌患者,可以有效地减少术中的出血量,缩短术中时间,对淋巴结的完全清除,加快术后的康复,减少术后并发症、肿瘤转移率和复发率,从而提高患者的生存率。

Objective To explore the complications and prognostic observation of laparoscopic membrane dissection of gastric cancer D2 combined with complete mesoeolic excision(CME) of the dorsal gastric plexus near the gastric end for the treatment of gastric cancer.Methods A total of 100 patients with gastric cancer admitted to Quanzhou First Hospital from January 2019 to January 2022 were randomly selected as the study objects,and were divided into control group(50 cases) and observation group(50 cases) by random number table method.The control group was treated with laparoscopic D2 radical resection,and the observation group was treated with laparoscopic D2 combined with CME radical resection.The relevant indexes of surgery and postoperative recovery,the occurrence of complications and prognosis of the two groups were compared.Results The number of lymph node dissection in observation group was more than that in control group,the amount of intraoperative blood loss was less,and the operation time was shorter than that in control group,and the differences were statistically significant(all P<0.05).The time of first exhalation,getting out of bed,resuming general eating and hospitalization in the observation group were shorter than those in the control group,and the differences were statistically significant(all P<0.05).The complication rate of observation group(4.00%) was lower than that of control group(16.00%),and the difference was statistically significant(χ^(2)=4.000,P<0.05).The 1-year tumor metastasis rate of observation group(12.00%) was lower than that of control group(30.00%),and the difference was statistically significant(P<0.05).The 1-year survival rate of observation group(90.00%) was higher than that of control group(74.00%),and the difference was statistically significant(P<0.05).Conclusion Laparoscopic membrane dissection D2 combined with CME radical resection for gastric cancer patients can effectively reduce intraoperative blood loss,shorten intraoperative time,complete lymph node removal,accelerate postoperative rehabilitation,reduce postoperative complications,tumor metastasis rate and recurrence rate,and thus improve the survival rate of patients.