目的:探讨3D腹腔镜根治性切除术在食管胃结合部腺癌中的优势和近期疗效。方法:回顾性分析山东大学齐鲁医院胃肠外科2018年1月-2019年4月39例3D腹腔镜根治性切除术治疗食管胃结合部腺癌患者的临床资料,并与同期37例行2D腹腔镜手术的患者...目的:探讨3D腹腔镜根治性切除术在食管胃结合部腺癌中的优势和近期疗效。方法:回顾性分析山东大学齐鲁医院胃肠外科2018年1月-2019年4月39例3D腹腔镜根治性切除术治疗食管胃结合部腺癌患者的临床资料,并与同期37例行2D腹腔镜手术的患者的临床资料比较,比较2组患者在术前一般资料、手术时间、淋巴结清扫数量、术中出血等手术指标以及术后并发症、术后排气时间、术后住院时间等近期疗效指标方面的差异。结果:两组患者的一般资料差异无统计学意义(P>0.05);两组患者均顺利完成手术,无中转开腹。3D组手术时间明显短于2D组(201±25.9 min vs 257.6±38.6 min,P<0.05);与2D组比较,3D手术组术中出血更少(57.3±31.3 mL vs 86.2±58.6 mL,P<0.05);淋巴结清扫数目更多(32.6±10.1枚vs 24.1±8.2枚,P<0.05),而术后排气时间、术后住院时间、术后并发症发生率方面的差异无统计学意义(P均>0.05)。结论:与2D腹腔镜相比,3D腹腔镜下食管胃结合部腺癌的根治性切除在缩短手术时间,减少术中出血量及增加淋巴结清扫数目方面优势明显,且没有增加术后住院时间及并发症发生率,值得临床进一步推广。展开更多
Surgical resection is preferred in the treatment of gastrointestinal stromal tumor （GIST）. Duodenal GIST comprises 4.5% of all GISTs, but the optimal surgical procedure for it remains uncertain. Since GISTs grow ext...Surgical resection is preferred in the treatment of gastrointestinal stromal tumor （GIST）. Duodenal GIST comprises 4.5% of all GISTs, but the optimal surgical procedure for it remains uncertain. Since GISTs grow extensively and rarely give rise to lymph node metastasis, pancreatoduodenectomy, which has been used to treat duodenal GIST, may be excessive for this disease. On the contrary, pancreas-sparing duodenectomy has only been performed in a few hospitals because the procedure requires precise anatomical knowledge of the pancreatic head. We successfully performed partial duodenectomy and translocation of the distal common bile duct as a patch to repair the defect in a patient with duodenal GIST close to the papilla of Vater.展开更多
文摘目的:探讨3D腹腔镜根治性切除术在食管胃结合部腺癌中的优势和近期疗效。方法:回顾性分析山东大学齐鲁医院胃肠外科2018年1月-2019年4月39例3D腹腔镜根治性切除术治疗食管胃结合部腺癌患者的临床资料,并与同期37例行2D腹腔镜手术的患者的临床资料比较,比较2组患者在术前一般资料、手术时间、淋巴结清扫数量、术中出血等手术指标以及术后并发症、术后排气时间、术后住院时间等近期疗效指标方面的差异。结果:两组患者的一般资料差异无统计学意义(P>0.05);两组患者均顺利完成手术,无中转开腹。3D组手术时间明显短于2D组(201±25.9 min vs 257.6±38.6 min,P<0.05);与2D组比较,3D手术组术中出血更少(57.3±31.3 mL vs 86.2±58.6 mL,P<0.05);淋巴结清扫数目更多(32.6±10.1枚vs 24.1±8.2枚,P<0.05),而术后排气时间、术后住院时间、术后并发症发生率方面的差异无统计学意义(P均>0.05)。结论:与2D腹腔镜相比,3D腹腔镜下食管胃结合部腺癌的根治性切除在缩短手术时间,减少术中出血量及增加淋巴结清扫数目方面优势明显,且没有增加术后住院时间及并发症发生率,值得临床进一步推广。
文摘Surgical resection is preferred in the treatment of gastrointestinal stromal tumor （GIST）. Duodenal GIST comprises 4.5% of all GISTs, but the optimal surgical procedure for it remains uncertain. Since GISTs grow extensively and rarely give rise to lymph node metastasis, pancreatoduodenectomy, which has been used to treat duodenal GIST, may be excessive for this disease. On the contrary, pancreas-sparing duodenectomy has only been performed in a few hospitals because the procedure requires precise anatomical knowledge of the pancreatic head. We successfully performed partial duodenectomy and translocation of the distal common bile duct as a patch to repair the defect in a patient with duodenal GIST close to the papilla of Vater.
