腹腔镜辅助与开腹胃癌根治术临床效果及对肠道屏障功能影响的比较

发布时间：2018-05-13 04:21

本文选题：胃肿瘤 + 胃切除术　；参考：《中国普通外科杂志》2017年04期

【摘要】：目的:比较腹腔镜胃癌根治术与传统开腹胃癌根治术对患者临床指标及术后肠道屏障功能的影响。方法:选择2016年1月—2016年6月符合条件的41例胃癌患者,其中21例行腹腔镜辅助胃癌D_2根治术(腔镜组),20例行开腹胃癌D_2根治术(开腹组)。比较两组患者相关临床指标及手术前后血浆二胺氧化酶(DAO)和内毒素(ETX)水平的变化。结果:两组患者的基本临床资料具有可比性。腔镜组手术切口长度、术中出血量均优于开腹组,但手术时间长于开腹组(均P0.05),其他临床指标包括术中输血比例、清扫淋巴结数量、手术切缘、术后通气时间两组间差异无统计学意义(均P0.05)。两组患者术后第1天DAO和ETX水平均较术前明显升高(均P0.05),但随后均将至术前水平,两组术前与术后各时间点DAO和ETX水平差异均无统计学意义(均P0.05),且DAO和ETX水平在两组患者中均呈正相关(r=0.759、r=0.559,均P0.05)。两组感染性并发症发生率无统计学差异(P0.05)。结论:腹腔镜辅助胃癌根治术与传统开腹胃癌根治术同样安全、有效,且对肠道屏障功能影响无明显增加。
[Abstract]:Objective: to compare the effect of laparoscopic radical gastrectomy and traditional open radical gastrectomy on clinical indexes and intestinal barrier function. Methods: 41 patients with gastric cancer were selected from January 2016 to June 2016, of which 21 cases were treated with laparoscopy assisted radical operation of gastric cancer (20 cases of endoscopic group were treated with D2 radical operation of gastric cancer). The changes of plasma diamine oxidase (DAO) and endotoxin (ETX) levels before and after operation were compared between the two groups. Results: the basic clinical data of the two groups were comparable. The operative incision length and bleeding volume in the endoscopic group were better than those in the laparotomy group, but the operative time was longer than that in the open group (all P 0.05). Other clinical parameters included the proportion of blood transfusion during operation, the number of lymph nodes dissected, and the margin of operation. There was no significant difference in postoperative ventilation time between the two groups (P 0.05). On the first day after operation, the levels of DAO and ETX in both groups were significantly higher than those before operation (P 0.05), but both of them would reach the preoperative level. There was no significant difference in the levels of DAO and ETX between the two groups before and after operation (P 0.05), and there was a positive correlation between DAO and ETX in the two groups (P 0.05). There was no significant difference in the incidence of infectious complications between the two groups (P 0.05). Conclusion: laparoscopic assisted radical gastrectomy is as safe and effective as traditional radical gastrectomy and has no significant effect on intestinal barrier function.
【作者单位】：安徽省铜陵市人民医院胃肠外科;
【分类号】：R735.2

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