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| 不同腹腔镜术式治疗近端胃癌的效果比较 |
| Comparisonof clinical outcomes of different laparoscopic surgical strategies for proximal gastric cancer |
| 投稿时间：2017-12-06 |
| DOI：10.3969/j.issn.1000-0399.2018.06.007 |
| 中文关键词: 近端胃癌 腹腔镜辅助下近端胃切除术 腹腔镜辅助下全胃切除术 经口置入钉砧头系统OrVilTM |
| 英文关键词: Proximal gastric cancer Laparoscopy-assisted proximal gastrectomy Laparoscopy-assisted total gastrectomy Transorally inserted anvil OrVilTM |
| 基金项目:安徽省科技计划项目（项目编号：1704a0802167） |
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| 摘要点击次数: 2011 |
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| 中文摘要: |
| 目的 探讨不同腹腔镜术式治疗近端胃癌（PGC）临床效果的差异。方法 回顾性分析2009年5月至2012年10月安徽医科大学第一附属医院胃肠腔镜外科行手术治疗的70例PGC患者的临床资料，其中23例行腹腔镜辅助下近端胃切除术（LAPG）为LAPG组，34例行腹腔镜辅助下全胃切除加食道空肠Roux-en-Y吻合术（LATG-RY）为LATG-RY组，13例行腹腔镜辅助下全胃切除加食道空肠OrVilTM吻合术（LATG-OrVilTM）为LATG-OrVilTM组，比较3组患者手术安全性、肿瘤根治情况、术后恢复情况及术后并发症发生情况。结果 LAPG组、LATG-RY组及LATG-OrVilTM组患者手术时间、术中出血量、TNM分期、远期并发症发生率及住院总费用的差异均有统计学意义（P<0.05）。LAPG组患者手术时间、术中出血量低于其他两组，Ⅰ期患者比例高于其他两组，远期并发症发生率高于其他两组，差异均有统计学意义（P<0.05）。LATG-OrVilTM组住院总费用高于其他两组，差异有统计学意义（P<0.05）。结论 LAPG、LATG-RY与LATG-OrVilTM治疗PGC均安全、有效。LAPG适用于早期PGC的治疗，LATG-RY治疗进展期PGC具有减少反流的优势，LATG-OrVilTM是治疗累及食管下段及食管胃结合部PGC的最佳选择。 |
| 英文摘要: |
| Objective To explore the clinical effect of different laparoscopy in the treatment of proximal gastric cancer (PGC).Methods The clinicaldata of 70 cases with PGC from May 2009 to October 2012 in the First Affiliated Hospital of Anhui Medical University were retrospectively analyzed, andamong them 23 underwent laparoscopy-assisted proximal gastrectomy (LAPG), 34 underwent laparoscopy-assisted total gastrectomy with Roux-en-Y esophagojejunostomy reconstruction through a mini-laparotomy (LATG-RY),and 13 underwent laparoscopy-assisted total gastrectomy with Roux-en-Y esophagojejunostomy anastomosed by the intracorporeal circular stapling technique with transorally inserted anvil OrVilTM (LATG-OrVilTM). The safety of the treatment, the radical treatment of the tumor, postoperative recovery and complications were compared among the three groups.Results There was significant difference in mean operative time, blood loss, TNM stage, late complications and hospitalization expenses among the three groups (P<0.05). The mean operative time and blood loss of LAPG group were significantly lower than those of the other two groups. Meanwhile, the proportion of patients in stage I and late complications were higher (P<0.05). Hospitalization expenses in LATG-OrVilTMgroup was higher than the other two groups (P<0.05).Conclusion LAPG, LATG-RY and LATG-OrvilTM are all safe and effective for PGC. LAPG is suitable for early PGC, LATG-RY has the advantage of reducing reflux in the treatment of advanced PGC, and LATG-OrVilTM may be optimal for PGC invasion of the EGJ and lower esophagus. |
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