摘要
目的:观察全腹腔镜远端胃癌根治术(TLDG)和腹腔镜辅助远端胃癌根治术(LADG)治疗胃癌患者对其淋巴结清扫情况、手术情况、炎症因子水平及预后的影响。方法:回顾性选择2020年1月到2024年8月收治的102例胃癌患者,按手术方法不同分为TLDG组(51例)、LADG组(51例)。比较两组淋巴结清扫情况、手术情况、炎症因子及预后。结果:两组淋巴结清扫总数、淋巴结阳性数差异无统计学意义(P>0.05)。TLDG组手术主切口长度及术后住院时间短于LADG组(P<0.05),TLDG组吻合时间长于LADG组(P<0.05)。术后24h,TLDG组C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)手术前后差值小于LADG组(P<0.05)。患者随访时间为4~59个月,TLDG组有7例因肿瘤相关事件死亡,累积生存率为73.00%,LADG组有5例因肿瘤相关事件死亡,累积生存率为78.10%,两组生存曲线差异无统计学意义(P>0.05)。结论:TLDG和LADG均为有效的治疗手段,但TLDG在术后恢复方面表现较好,手术主切口长度和住院时间较短,且炎症因子反应较小。
Objective:To observe the effects of totally laparoscopic distal gastrectomy(TLDG)and laparoscopic assisted distal gastrectomy(LADG)on lymph node dissection,surgical status,inflammatory factor levels,and prognosis in patients with gastric cancer.Methods:A total of 102 gastric cancer patients from January 2020 to August 2024 were retrospectively selected and divided into TLDG group and LADG group with 51 cases in each group according to different surgical methods.Lymph node dissection,surgical situation,inflammatory factors,and prognosis were compared between the two groups.Results:There were no statistically significant differences in the total number of lymph nodes cleared and the number of positive lymph nodes between the two groups(P>0.05).The length of the main incision and length of postoperative hospital stay in TLDG group were shorter than those in LADG group,and the time for anastomosis was longer than that in LADG group,with statistically significant differences(P<0.05).24h after surgery,the differences in C-reactive protein(CRP),tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)before and after surgery were smaller in TLDG group than in LADG group,with statistically significant differences(P<0.05).The patients were followed up for 4~59 months.There were 7 and 5 deaths in TLDG group and LADG group,respectively,due to tumor related events.The cumulative survival rates were 73.00%and 78.10%,respectively.There was no statistically significant difference in survival curve between the two groups(P>0.05).Conclusion:TLDG and LADG are both effective treatment methods.However,TLDG is better in terms of postoperative recovery,length of main incision,hospital stay,and inflammatory response.
作者
高梓豪
张成功
丁凡
代德柱
宋旭东
陶国全
GAO Zihao;ZHANG Chenggong;DING Fan(Huai'an First Hospital,Nanjing Medical University,Jiangsu Huai'an 223300,China)
出处
《河北医学》
2025年第7期1191-1195,共5页
Hebei Medicine
基金
2017年度国家自然科学基金资助项目,(编号:81773538)
江苏省医学重点学科实验室建设单位,(编号:JSDW202233)。
关键词
胃癌
根治性远端胃切除术
全腹腔镜
腹腔镜辅助
淋巴结清扫
Gastric cancer
Distal gastrectomy
Totally laparoscopic
Laparoscopic assisted
Lymph node dissection
