文章摘要

腹腔镜下近端胃切除术治疗近端早期胃癌

作者: 1金鑫, 1李福广, 2李立, 3冯利, 1王宁
1 陕西省安康市中心医院 普通外科,陕西 安康 725000
2 陕西师范大学医院 外科,陕西 西安 710000
3 陕西省安康市中心医院 肛肠科,陕西 安康 725000
通讯: 李福广 Email: aklifg@163.com
DOI: 10.3978/.10.3978/j.issn.1005-6947.2015.04.018

摘要

目的:探讨腹腔镜下近端胃切除术治疗近端早期胃癌的可行性与安全性。 方法:回顾性分析2007 年6 月—2010 年12 月间手术治疗的72 例近端早期胃癌患者资料,其中38 例 行腹腔镜下近端胃切除术(LAPG 组),34 例行腹腔镜下胃大部切除术(LAG 组)。比较两组患者的 一般情况、术中与术后各项指标,并用Visick 评分比较两组患者术后胃食管反流症状。 结果:两组患者年龄、性别、体质量指数、并存疾病、手术时间及术后住院天数差异均无统计学意义(均 P>0.05),但LAPG 组术中出血量明显少于LAG 组(P<0.05)。两组患者术后肛门排气时间、开始进 食时间及早、晚期并发症发生率差异均无统计学意义(均P>0.05),但LAPG 组术后Visick 评分明显 高于LAG 组(P<0.05)。两组患者术后病理指标、手术前后的营养学指标变化、术后生存率差异均无 统计学意义(均P>0.05)。 结论:腹腔镜下近端胃切除术能够安全的应用于近端早期胃癌的治疗,但应警惕术后胃食管反流症状 的发生。
关键词: 胃肿瘤 胃切除术,腹腔镜 胃食管反流

Laparoscopy-assisted proximal gastrectomy for early-stage proximal gastric cancer

Authors: 1JIN Xin, 1LI Fuguang, 2LI Li, 3FENG Li, 1WANG Ning
1 Department of General Surgery, Ankang Central Hospital, Ankang, Shannxi 725000, China
2 Department of Surgery, Shanxi Normal University Hospital, Xi’an 710000, China
3 Department of Anorectal Surgery, Ankang Central Hospital, Ankang, Shannxi 725000, China

CorrespondingAuthor:LI Fuguang Email: aklifg@163.com

Abstract

Objective: To evaluate feasibility and safety of laparoscopy-assisted proximal gastrectomy in treatment of earlystage proximal gastric cancer. Methods: The clinical data of 72 patients with early-stage proximal gastric cancer undergoing surgical treatment from June 2007 to December 2010 were retrospectively analyzed. Of the patients, 38 cases underwent laparoscopy-assisted proximal gastrectomy (LAPG group) and laparoscopy-assisted subtotal gastrectomy (LAG group). The general conditions, intra- and postoperative variables were compared, and the symptoms of gastroesophageal reflux after surgery between the two groups were also compared by using Visick score. Results: No significant difference was noted in age, gender, body mass index, concomitant disease, operative time and length of postoperative hospital stay between the two groups (all P>0.05), but the intraoperative blood loss in LAPG group was significantly reduced compared with LAG group (P<0.05). The time to first postoperative flatus and food intake, and incidence of early and delayed complications after surgery showed no significant difference between the two groups (all P>0.05), but the postoperative Visick score in LAPG group was significantly higher than that in LAG group (P<0.05). The postoperative pathological parameters, pre- and postoperative changes in nutritional parameters and postoperative survival rate between the two groups showed no significant difference (all P>0.05). Conclusion: laparoscopy-assisted proximal gastrectomy can be safely used in treatment of early proximal gastric cancer and however, the occurrence of postoperative gastroesophageal reflux should be monitored carefully.
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