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中华普通外科学文献(电子版) ›› 2019, Vol. 13 ›› Issue (02) : 143 -147. doi: 10.3877/cma.j.issn.1674-0793.2019.02.012

所属专题: 文献

论著

全腹腔镜、腹腔镜辅助与开腹胃癌根治术治疗Ⅱ、Ⅲ期胃癌的疗效对比
葛宏升1,(), 周军1, 魏海梁1   
  1. 1. 712000 咸阳,陕西中医药大学附属医院普外一科
  • 收稿日期:2018-06-09 出版日期:2019-04-01
  • 通信作者: 葛宏升

Comparison of the efficacy of total laparoscopic, laparoscopic-assisted and traditional radical gastrectomy for gastric cancer with stage Ⅱand Ⅲ

Hongsheng Ge1,(), Jun Zhou1, Hailiang Wei1   

  1. 1. The First Department of General Surgery, Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine, Xianyang 712000, China
  • Received:2018-06-09 Published:2019-04-01
  • Corresponding author: Hongsheng Ge
  • About author:
    Corresponding author: Ge Hongsheng, Email:
引用本文:

葛宏升, 周军, 魏海梁. 全腹腔镜、腹腔镜辅助与开腹胃癌根治术治疗Ⅱ、Ⅲ期胃癌的疗效对比[J/OL]. 中华普通外科学文献(电子版), 2019, 13(02): 143-147.

Hongsheng Ge, Jun Zhou, Hailiang Wei. Comparison of the efficacy of total laparoscopic, laparoscopic-assisted and traditional radical gastrectomy for gastric cancer with stage Ⅱand Ⅲ[J/OL]. Chinese Archives of General Surgery(Electronic Edition), 2019, 13(02): 143-147.

目的

探讨全腹腔镜胃癌根治术(TLG)、腹腔镜辅助胃癌根治术(LAG)与传统开腹术(TOS)对Ⅱ、Ⅲ期胃癌的近期及远期疗效。

方法

回顾性分析2013年1月至2016年6月陕西中医药大学附属医院行胃癌根治术的患者共136例,根据患者手术方式的不同分为TLG组(45例),LAG组(40例),TOS组(51例)。观察和比较3组患者手术时间、出血量、淋巴结清扫数、术后排气时间、住院时间、术后并发症发生情况,采用Kaplan-Meier法对患者术后5年远期疗效进行生存分析。

结果

TLG组患者出血量、排气时间及住院时间低于TOS组及LAG组,LAG组患者手术时间高于TLG组及TOS组,差异均有统计学意义(P<0.05);3组患者术后并发症发生率比较,差异无统计学意义。共129例获得随访,其中TLG组失访2例,LAG组2例,TOS组3例。TLG、LAG、TOS组平均无瘤生存时间为(53.4±2.1)个月(95%CI=50.45~58.22个月)、(54.3±2.0)个月(95%CI= 47.99~56.18个月)、(52.3±2.1)个月(95%CI=50.98~55.65个月),3组患者无瘤生存时间比较,差异无统计学意义(F=0.519,P=0.772)。

结论

TLG术能够在保证患者术后疗效的同时,降低患者术中出血量、排气时间及术后住院时间,TLG术治疗Ⅱ、Ⅲ期胃癌安全可行,疗效显著,值得推广。

Objective

To explore the short-term and long-term effects of totally laparoscopic gastrectomy (TLG), laparoscopy-assisted gastrectomy (LAG), and traditional radical surgery (TOS) for gastric cancer with stage and .

Methods

This study reviewed one hundred and thirty-six patients who underwent radical gastrectomy in Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine from January 2013 to June 2016. According to the different methods of operation, the patients were divided into TLG group (45 cases), LAG group (40 cases) and TOS group (51 cases). The operative time, bleeding volume, lymph node clearance, postoperative exhaust time, hospital stay, postoperative complications and were observed. 5-year survival after operation was analyzed by Kaplan-Meier method.

Results

The bleeding volume, exhaust time and hospital stay in group TLG were significantly lower than those in group TOS and LAG (P<0.05). The operative time in group LAG was significantly higher than that in the other two groups (P<0.05). There was no significant difference in the complication rate in the three groups. In this study, 129 patients were followed up, with 2 in group TLG, 2 in group LAG and 3 in group TOS failing to be followed up. The average tumor-free survival time in TLG, LAG and TOS groups was [(53.4±2.1) months, 95%CI (50.45, 58.22) months; (54.3±2.0) months, 95%CI (47.99, 56.18) months; (52.3±2.1) months, 95%CI (50.98, 55.65) months], with no significant difference among the three groups (F=0.519, P=0.772).

Conclusions

TLG can reduce the amount of bleeding, the time of exhaust and the time of hospitalization, while ensuring the postoperative effect of the patients. TLG is safe and feasible for the treatment of stage and Ⅲ gastric cancer, and is worth popularizing.

表1 3组胃癌根治术患者基本资料比较
表2 3组胃癌根治术患者手术情况比较(方差分析,±s
表3 3组胃癌根治术患者外科并发症Clavien-Dindo分级比较[例(%)]
表4 3组胃癌根治术患者术后随访情况比较[例(%)]
图1 3组胃癌患者术后5年的生存曲线
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