腹腔镜辅助全胃切除术治疗进展期胃癌的临床研究

发布时间：2018-05-31 17:31

本文选题：腹腔镜 + 胃切除术　；参考：《兰州大学》2015年硕士论文

【摘要】：目的：通过比较腹腔镜辅助与开腹全胃切除术治疗进展期胃癌的临床疗效,评估腹腔镜辅助下全胃切除术治疗进展期胃癌的可行性和手术安全性。方法：收集2013年7月至2015年1月在兰州大学第二医院普外科手术治疗的进展期胃癌患者170例(腹腔镜辅助下全胃切除术65例,开腹全胃切除术105例)。分析比较两组患者的基本资料、病理特征、围手术期临床结果、术后并发症。结果：与开腹全胃切除术相比,腹腔镜辅助下全胃切除术治疗进展期胃癌的淋巴结清扫数目无显著性差异,腹腔镜组术后住院时间短,术后通气时间早,首次进食时间早,术中出血量少,术后并发症少,术后疼痛轻等优点；但是,腹腔镜组手术时间较长。结论：腹腔镜辅助下全胃切除术治疗进展期胃癌的根治程度与开腹全胃切除术相似,且具有创伤小、恢复快、并发症发生率较低等优势。目的：系统评价腹腔镜辅助全胃切除术与开腹全胃切除术治疗进展期胃癌的手术安全性和淋巴结清扫程度。方法：计算机检索CENTRAL Medline (Pubmed)、Embase、中国生物医学文献数据库、万方数据库及中国知网数据库等,检索日期自1994年1月至2014年3月。纳入腹腔镜辅助全胃切除术对比开腹全胃切除术治疗进展期胃癌的所有随机对照试验和非随机对照研究,对纳入文献进行质量评价,并使用RevMan5.2软件进行数据分析处理。结果：最终纳入6篇文献,共1,115例(腹腔镜组547例,开腹组568例)患者。与开腹全胃切除术相比,腹腔镜辅助全胃切除术治疗进展期胃癌术后并发症少,术中出血量少,术后住院时间短,但手术时间较长,两种术式淋巴结清扫数目无明显差异。结论：腹腔镜辅助全胃切除术治疗进展期胃癌与开腹全胃切除术相比有一定的微创优势,手术安全性好,且淋巴结清扫程度相似。
[Abstract]:Objective: to evaluate the feasibility and safety of laparoscopic assisted total gastrectomy in the treatment of advanced gastric cancer. Methods: from July 2013 to January 2015, 170 patients with advanced gastric cancer were treated by general surgery in the second Hospital of Lanzhou University, including 65 cases of total gastrectomy assisted by laparoscope and 105 cases of total gastrectomy. The basic data, pathological features, perioperative clinical results and postoperative complications were analyzed and compared between the two groups. Results: there was no significant difference in the number of lymph node dissection between laparoscopic assisted total gastrectomy and open gastrectomy. There were less intraoperative bleeding, less postoperative complications and less postoperative pain, but the operative time was longer in the laparoscopic group. Conclusion: laparoscopic assisted total gastrectomy is similar to open gastrectomy in the treatment of advanced gastric cancer, and has the advantages of less trauma, faster recovery and lower incidence of complications. Objective: to evaluate the safety and lymph node dissection of laparoscopic assisted total gastrectomy and open total gastrectomy in the treatment of advanced gastric cancer. Methods: CENTRAL Medline Pubmeda Embase, Chinese Biomedical Literature Database, Wanfang Database and China knowledge Network Database were searched by computer from January 1994 to March 2014. All randomized controlled trials and non-randomized controlled trials involving laparoscopic assisted total gastrectomy and open gastrectomy for advanced gastric cancer were included. The quality of the literature was evaluated and the data were analyzed with RevMan5.2 software. Results: a total of 1115 cases (547 cases of laparoscopic group and 568 cases of open group) were included in 6 articles. Compared with open gastrectomy, laparoscopic assisted total gastrectomy has less complications, less intraoperative bleeding, shorter postoperative hospital stay, but longer operation time. There is no significant difference in the number of lymph nodes dissection between the two operations. Conclusion: Laparoscopy-assisted total gastrectomy has some advantages over open total gastrectomy in the treatment of advanced gastric cancer. The operation is safe and the degree of lymph node dissection is similar.
【学位授予单位】：兰州大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R735.2

【共引文献】