腹腔镜辅助全胃切除手术在不同年龄段局部进展期胃癌患者中的应用效果

Application effect of laparoscopic assisted total gastrectomy in patients with locally advanced gastric cancer at different ages

目的分析腹腔镜辅助全胃切除手术在不同年龄段局部进展期胃癌(LAGC)患者中的应用效果。方法选择2017年4月至2023年4月收治的80例LAGC患者纳入本次研究,以年龄段将其分为A组(≤55岁,n=11)、B组(56~70岁,n=28)、C组(>70岁,n=41)。三组均给予腹腔镜辅助全胃切除手术治疗。比较三组的手术效果。结果三组的手术时长、术中失血量、淋巴结清扫数量、术后排气时间、恢复正常饮食时间、总住院时长比较,差异无统计学意义(P>0.05)。三组的术后并发症总发生率比较,差异无统计学意义(P>0.05)。术前、术后,三组的C反应蛋白(CRP)、去甲肾上腺素(NE)、前列腺素E_(2)(PGE_(2))、髓过氧化物酶(MPO)、癌胚抗原(CEA)、糖类抗原199(CA199)、糖类抗原724(CA724)水平比较,差异无统计学意义(P>0.05);术后,三组的CRP、NE、PGE_(2)、MPO水平均高于术前,CEA、CA199、CA724水平低于术前,差异具有统计学意义(P<0.05)。结论腹腔镜辅助全胃切除手术应用于不同年龄段LAGC患者中均可取得较佳手术效果,且未增加应激反应及严重并发症,值得临床应用与推广。

Objective To analyze the application effect of laparoscopic assisted total gastrectomy in patients with locally advanced gastric cancer(LAGC)at different ages.Methods A total of 80 patients with LAGC admitted from April 2017 to April 2023 were enrolled in this study.The patients were divided into group A(≤55 years old,n=11),group B(56-70 years old,n=28)and group C(>70 years old,n=41).All three groups were treated with laparoscopic assisted total gastrectomy.The surgical effects of the three groups were compared.Results There were no significant differences in operation time,intraoperative blood loss,number of lymph node dissection,postoperative exhaust time,time to return to normal diet and total hospitalization time among the three groups(P>0.05).There was no significant difference in the total incidence of postoperative complications among the three groups(P>0.05).Before and after operation,the levels of C-reactive protein(CRP),norepinephrine(NE),prostaglandin E_(2)(PGE_(2)),myeloperoxidase(MPO),carcinoembryonic antigen(CEA),carbohydrate antigen 199(CA199)and carbohydrate antigen 724(CA724)were compared among the three groups,the differences were not statistically significant(P>0.05);after operation,the levels of CRP,NE,PGE_(2) and MPO in the three groups were higher than those before operation,and the levels of CEA,CA199 and CA724 were lower than those before operation,the differences were statistically significant(P<0.05).Conclusion Laparoscopic assisted total gastrectomy can achieve better surgical results in LAGC patients of different ages,and does not increase stress response and serious complications,which is worthy of clinical application and promotion.