基于膜解剖D2+CME根治术治疗胃癌的近中期随访研究

Near-and medium-term follow-up study of radical resection of gastric cancer based on membrane anatomy D2+CME

目的基于膜解剖理念探讨腹腔镜D2根治术联合完整系膜切除(CME)治疗胃癌的近中期效果。方法回顾性分析2020年1月至2022年12月95例进展期胃癌患者资料,均完成胃癌外科治疗,并获得2年随访信息。根据不同手术方法分为两组,膜解剖组50例(行胃癌D2根治术+CME),传统组45例(行胃癌D2根治术)。数据采用SPSS 25.0软件处理,围手术期指标等计量资料用()表示,采用独立样本t检验;术后30 d内并发症、术后2年内复发率等计数资料采用卡方检验。P<0.05表示差异有统计学意义。结果膜解剖组患者术中出血量、首次排气时间、排便时间、住院时间均少于传统组,淋巴结清扫数目多于传统组(P<0.05);两组患者并发症发生率比较,差异无统计学意义(P>0.05);膜解剖组患者复发时间相比传统组延长,术后2年内累积复发病例少于传统组(P<0.05)。结论基于膜解剖D2+CME根治术治疗胃癌能减少术中出血量,缩短胃肠功能恢复时间及住院时间,且具有减少复发的优势。

Objective To investigate the efficacy of laparoscopic D2 radical resection combined with complete mesangectomy(CME)in the treatment of gastric cancer based on the concept of membrane anatomy.Methods Data of 95 patients with advanced gastric cancer from January 2020 to December 2022 were retrospectively analyzed,all of whom completed surgical treatment for gastric cancer,and 2-year follow-up information was obtained.They were divided into two groups according to different surgical methods:50 cases in the membrane dissection group(D2 radical resection+CME)and 45 cases in the traditional group(D2 radical resection).SPSS 25.0 software was used to process the data.Measurement data such as perioperative indicators were expressed as()and independent sample t test was used.Chi-square test was used to measure complications within 30 days and recurrence rate within 2 years.P<0.05 indicated that the difference was statistically significant.Results The amount of intraoperative blood loss,first exhaust time,defecation time and hospital stay in the membrane dissection group were lower than those in the traditional group,and the number of lymph node dissection was higher than that in the traditional group(P<0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).The recurrence time of patients in membrane anatomy group was longer than that in traditional group,and the cumulative recurrence cases in 2 years were less than that in traditional group(P<0.05).Conclusion D2+CME radical surgery based on membrane anatomy can reduce the amount of intraoperative blood loss,shorten the time of gastrointestinal function recovery and hospital stay,and has the advantage of reducing recurrence.