摘要
目的探讨腹腔镜下胃癌根治术治疗进展期胃癌患者的临床疗效。方法根据手术方式将192例接受手术治疗的进展期胃癌患者分为腹腔镜组和传统组,每组96例。传统组患者采用开腹手术方式,腹腔镜组患者采用腹腔镜下手术方式。比较两组患者的手术指标(切口长度、手术时间、淋巴结清扫数目、术中出血量)、术后恢复指标(首次排气时间、首次进食时间、首次下床活动时间、术后疼痛评分、住院时间)及术后并发症发生情况。观察两组患者术前、术后血清炎性因子[白细胞介素-6(IL-6)、超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)]及应激反应指标[5-羟色胺(5-HT)、P物质(SP)、去甲肾上腺素(NE)]的变化情况。结果腹腔镜组患者切口长度明显短于传统组,术中出血量明显少于传统组,手术时间明显长于传统组,术后首次排气时间、首次进食时间、首次下床活动时间、住院时间均明显短于传统组,术后疼痛评分明显低于传统组,术后并发症总发生率明显低于传统组,差异均有统计学意义(P﹤0.01)。两组患者淋巴结清扫数目比较,差异无统计学意义(P﹥0.05)。术后,两组患者血清炎性因子水平、应激反应指标水平均高于本组术前,且腹腔镜组血清炎性因子水平、应激反应指标水平均低于传统组,差异均有统计学意义(P﹤0.05)。结论胸腔镜下胃癌根治术治疗进展期胃癌患者可达传统开腹术切除水平,能够减轻患者术后应激反应与炎性反应,降低术后并发症总发生率。
Objective To explore the clinical efficacy of laparoscopic radical gastrectomy in progressive gastric cancer.Method A total of 192 patients with advanced gastric cancer who received surgical treatment were divided into traditional group and laparoscopic group,96 cases in each group.The traditional group was treated with open surgery,the laparoscopic group was treated with laparoscopic surgery.The operation indexes(incision length,operation time,number of lymph node cleaning,intraoperative blood loss),postoperative recovery index(postoperative exhaust time,postoperative recovery time in feeding,ambulation time,postoperative pain score,hospitalization time)and postoperative complications were compared between the two groups.The changes of preoperative and postoperative serum inflammatory factors of interleukin 6(IL-6),hypersensitive C-reactive protein(hs-CRP)and tumor necrosis factor-α(TNF-α),stress response indexes of 5-hydroxytryptamine(5-HT),substance P(SP)and norepinephrine(NE)were observed.Result The incision length and intraoperative blood loss of the laparoscopic group were lower than those of the traditional group;the operation time was longer than that of the traditional group;the first exhaust time,the first eating recovery time,the first ambulation time,the postoperative pain score and the hospitalization time of the laparoscopic group were less than those of the traditional group;the total incidence of postoperative complications was lower than that of the traditional group,the differences were statistically significant(P<0.01).There was no significant difference in the number of lymph node dissection between the two groups(P>0.05).After operation,the levels of serum inflammatory factors and stress reaction indexes in the two groups were higher than those before operation,but the levels of serum inflammatory factors and stress reaction indexes in the laparoscopic group were lower than those in the traditional group,the differences were statistically significant(P<0.05).Conclusion Laparoscopic radical gastrectomy in progressive gastric cancer can reach similar efficacy as traditional open surgery,alleviate postoperative stress response and inflammatory reactions,and reduce the incidence of postoperative complications.
作者
李建军
乔泽强
庞召果
郭玉申
LI Jianjun;QIAO Zeqiang;PANG Zhaoguo;GUO Yushen(Department of Seventh Surgery,the Second Affiliated Hospital of Nanyang Medical College,Nanyang 473000,He’nan,China)
出处
《癌症进展》
2021年第10期1035-1038,共4页
Oncology Progress
关键词
胃癌
进展期
腹腔镜
开腹手术
临床疗效
gastric cancer
progressive
laparoscope
open surgery
clinical efficacy
作者简介
通信作者:李建军,邮箱:1031987945@qq.com。
