进展期胃癌根治术中胰腺上方胃系膜切除入路选择比较

Comparison of the Choice of the Approache of Mesogastrium Excision Above Pancreas in Radical Gastrectomy for Advanced Gastric Cancer

目的:比较胰腺上方胃系膜切除不同入路方式在进展期胃癌根治术患者中的应用效果。方法:选取2020年6月—2021年6月平煤神马医疗集团总医院收治的82例进展期胃癌患者作为研究对象,根据手术入路方式的不同将采用经左侧胰腺上方切除胃系膜的患者作为对照组(n=40),经右侧胰腺上方切除胃系膜患者作为观察组(n=42)。对照组采用经左侧胰腺上方切除胃系膜,观察组采用经右侧胰腺上方切除胃系膜。比较两组患者的手术情况、术后恢复情况、术后病理结果、术后疼痛程度及随访情况。结果:观察组患者手术持续时间短于对照组、术中出血量少于对照组,差异有统计学意义(t=4.911,P<0.05);观察组患者淋巴结清扫数量多于对照组,差异有统计学意义(t=5.730,P<0.05)。结论:进展期胃癌根治术患者采用经左侧与经右侧入路切除胰腺上方胃系膜的治疗效果相当,但经右侧入路可以缩短手术持续时间,降低术中出血量,淋巴结清扫数量更多。

Objective:To compare the application effect of different approaches of mesogastrium excision above pancreas in patients with advanced gastric cancer undergoing radical resection.Methods:82 patients with advanced gastric cancer who underwent radical gastrectomy in the hospital from June 2020 to June 2021 were selected as the study subjects.According to the different ways of approaching,the data of 40 patients who underwent mesogastrium excision via the upper left pancreas were included in the control group,and the data of 42 patients who underwent mesogastrium excision via the upper right pancreas were included in the observation group.The operation,postoperative recovery,postoperative pathological results,postoperative pain degree and follow-up were compared between the two groups.Results:The duration of operation in the observation group was shorter than that in the control group,the amount of intraoperative bleeding was less than that in the control group(t=4.911,P<0.05).The number of lymph node dissection was more than that in the control group,and the difference was statistically significant(t=5.730,P<0.05).Conclusion:The curative effect of mesogastrium excision above pancreas through the left and right approaches is the same in patients with advanced gastric cancer undergoing radical surgery,but the right approach can shorten the operation duration,reduce intraoperative bleeding,and increase the number of lymph node dissection.