摘要
目的 探讨脾门区血管淋巴结清扫在进展期近端胃癌根治术患者中的应用效果。方法 回顾性分析2018年9月至2021年9月于榆林市第二医院普外科和西电集团医院普外科接受手术治疗的120例进展期近端胃癌根治术患者的临床资料,两组患者均采用近侧胃癌根治术,按照淋巴结清扫范围分组,其中50例给予原位腹腔淋巴结清扫者纳入对照组,70例给予脾门区血管淋巴结清扫者纳入观察组,比较两组患者的淋巴清扫总数、平均幽门下区淋巴结数目、淋巴结阳性发生率以及围术期指标,并比较两组患者清扫前后的白细胞介素-6 (IL-6)、超敏C反应蛋白(hs-CRP)水平及术后并发症发生情况。结果 两组患者的平均淋巴清扫总数和平均幽门下区淋巴结数目比较差异均无统计学意义(P>0.05);观察组患者的淋巴结阳性发生率为5.71%,明显低于对照组的18.00%,差异具有统计学意义(P<0.05);观察组患者的手术时间、术中出血量、排气时间和住院恢复时间分别为(197.64±43.46) min、(217.64±45.46) mL、(32.64±5.46) h和(10.64±5.78) d;明显短(少)于对照组的(287.38±54.89) min、(279.59±43.69) m L、(38.79±6.58) h和(15.79±6.36) d,差异均具有统计学意义(P<0.05);观察组患者的术后并发症总发生率为8.57%,明显低于对照组的32%,差异有统计学意义(P<0.05);清扫前,两组患者的IL-6和hs-CRP水平比较差异均无统计学意义(P>0.05);清扫后,观察组患者的IL-6和hs-CRP水平分别为(42.98±11.21)μg/mL、(8.36±2.97)μg/mL,明显低于对照组的(52.83±10.26)μg/mL、(16.65±6.98)μg/mL,差异均具有统计学意义(P<0.05)。结论 脾门区血管淋巴结清扫术可有效提高进展期近端胃癌根治术患者的治疗效果,能够有效清除体内淋巴结,且能缩短手术时间,降低术后并发症,减轻炎症反应,有利于促进患者术后恢复,具有较高的临床应用价值。
Objective To investigate the application effect of splenic hilar vascular lymph node dissection in patients with advanced proximal gastric cancer undergoing radical resection.Methods The clinical data of 120 patients with advanced proximal gastric cancer who received radical resection in Department of General Surgery,Yulin No.2 Hospital and Department of General Surgery,Xi’an XD Group Hospital from September 2018 to September 2021 were retrospectively analyzed.According to the scope of lymph node dissection,50 patients who received in situ abdominal lymph node dissection were included in the control group,and 70 patients who received splenic hilar vascular lymph node dissection were included in the observation group.The total number of lymph nodes dissected,the average number of lymph nodes in the subpyloric region,the incidence of positive lymph nodes,and perioperative indicators were compared between the two groups,as well as the levels of interleukin-6(IL-6),high-sensitivity C-reactive protein(hs-CRP)level,and postoperative complications.Results There was no significant difference in the average total number of lymph nodes dissected and the average number of lymph nodes in the subpyloric region between the two groups(P>0.05).The incidence of positive lymph nodes in the observation group was 5.71%,which was significantly lower than18.00% in the control group(P0.05).After lymph node dissection,the levels of IL-6 and hs-CRP in the observation group were(42.98±11.21) μg/mL and(8.36±2.97) μg/mL,which were significantly lower than(52.83±10.26) μg/mL,(16.65±6.98) μg/mL in the control group(P<0.05).Conclusion Splenic hilar vascular lymph node dissection can effectively improve the therapeutic effect of patients with advanced proximal gastric cancer undergoing radical resection,effectively remove the lymph nodes in the body,shorten the operation time,reduce postoperative complications,and alleviate inflammatory response.It is beneficial to promote postoperative recovery and has high clinical application value.
作者
马任远
常娜
王兴国
牟亚刚
MA Ren-yuan;CHANG Na;WANG Xing-guo;MOU Ya-gang(Department of General Surgery,Yulin No.2 Hospital,Yulin 719000,Shaanxi,CHINA;Department of General Surgery,Xi'an XD Group Hospital,Xi'an 710077,Shaanxi,CHINA)
出处
《海南医学》
CAS
2022年第19期2508-2511,共4页
Hainan Medical Journal
基金
陕西省科技厅科研基金资助项目(编号:2018231)。
关键词
脾门区血管淋巴结清扫
胃癌根治术
临床疗效
炎症因子
并发症
Splenic hilar vascular lymph node dissection
Radical resection for gastric cancer
Clinical efficacy
Inflammatory factors
Complications
