摘要
目的比较腹腔镜与开腹胃癌根治术对区域淋巴结清扫及并发症的影响。方法选择2016年3月至2017年2月收治的68例胃癌患者,按照随机数字表法,分为腹腔镜组(34例)和开腹组(34例)。采用SPSS18.0版统计软件分析,手术相关指标、区域淋巴结清扫情况等计量资料采用均数±标准差表示,组间比较采用t检验;围术期并发症比较采用χ2检验,P<0.05认为差异有统计学意义。结果腹腔镜组的手术时间明显比开腹组延长,而术中出血量[(93.5±15.3)、(175.5±31.6)ml]、胃管拔除时间[(6.3±1.5)、(7.2±1.4)d]及肠鸣音恢复时间[(2.7±0.3)、(3.4±0.4)d]明显减少(t=24.43,13.60,2.45,3.04,P<0.05)。腹腔镜组脾门区域淋巴结清扫数多于开腹组[(3.9±0.4)、(3.7±0.3)](t=2.03,P<0.05);腹腔镜组Ⅰ~Ⅱ级并发症的发生率为8.9%,显著低于开腹组35.3%(χ2=6.93,P<0.05)。结论腹腔镜胃癌根治术在区域淋巴结清扫的彻底性与开腹手术相当,且可减少术后并发症。
Objective To compare the complications after laparoscopy and open gastrectomy with regional lymphadenectomy . Methods 68 patients with gastric cancer who received surgical treatment from Mar 2016 to Feb 2017 were enrolled into this study .According to the random number table , 68 patients were divided into laparoscopic group （n=34） and open group （n=34）.The data was statistically analyzed by using SPSS 18.0 software.Measurement data such as perioperative data and harvested lymph nodes were expressed as （x-±s） and were examined by t test.Count data such as postoperative complications rate were examined by chi square test , A P value of 〈0.05 was considered as statistically significant . Result Compared with open group, the operation time was obviously prolonged in laparoscopic group , and intraoperative blood loss [（93.5 ±15.3） vs.（175.5 ±31.6） ml], time of removing gastric tube [（6.3 ± 1.5） vs.（7.2 ±1.4） d], and recovery time of gurgling sound [（2.7 ±0.3） vs.（3.4 ±0.4） d], recovery time of bowel sounds [（2.7 ±0.3） vs.（3.4 ±0.4） d] were all decreased significantly （t=24.43, 13.60, 2.45, 3.04, P〈0.05）.The number of splenic hilar lymph nodes in laparoscopic group was more than that in open group [（3.9 ±0.4） vs.（3.7 ±0.3）] （t=2.03, P〈0.05）.The incidence of complications in gradeⅠ~Ⅱof laparoscopic group was 8.9%, which was significantly lower than 35.2% of open group （χ2 =6.93, P〈0.05）. Conclusions Laparoscopic gastrectomy which could reduce the postoperative complications , has similar effect of regional lymphadenectomy clearance as open surgery .
出处
《中华普外科手术学杂志（电子版）》
2017年第6期472-474,共3页
Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)
关键词
胃肿瘤
腹腔镜检查
胃切除术
淋巴结切除术
手术中并发症
Stomach Neoplasms
Laparoscopy
Gastrectomy
Lymph Node Excision
Intraoperative Complications
