| 周郑,顾问,吴文涌,等.手助腹腔镜在胃癌治疗中的临床评价[J].安徽医药,2016,20(10):1908-1912. |
| 手助腹腔镜在胃癌治疗中的临床评价 |
| A short-term clinical evaluation of hand assisted laparoscopic surgery in the treatment of gastric cancer |
| 投稿时间：2016-05-17 |
| DOI： |
| 中文关键词: 手助腹腔镜 开放手术 胃癌 近期临床评价 |
| 英文关键词: Hand assisted laparoscopy Open surgery Gastric cancer Short term clinical evaluation |
| 基金项目:国家自然科学基金面上项目(81572305);安徽省教育厅重点人才支持项目(gxyqZD2016051) |
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| 中文摘要: |
| 目的 评价手助腹腔镜在胃癌治疗中应用的近期临床疗效。方法 选择接受手助腹腔镜和开放手术的胃癌患者,收集患者术前、术后第1天以及术后第3天外周血,分别测定C-反应蛋白(CRP)、白细胞介素-6(IL-6)、皮质醇(COR)水平。同时收集患者的术前参数:患者的基本资料、合并的基础疾病及实验室指标；术中参数:手术时间、切口长度、术中出血量,淋巴结的阳性检出率,肿瘤的大小与分期,手术方式及手术性质；术后患者胃肠功能恢复时间、术后并发症的发生率及住院时间。结果 两组患者的术前各参数比较差异无统计学意义(P＞0.05)。手助腹腔镜组与开放手术组在术中淋巴结的阳性检出率,肿瘤的大小与分期,手术方式及手术性质上差异无统计学意义(P＞0.05);手助腹腔镜组患者的手术切口长度小于开腹手术组患者的切口长度[(5.07±0.41)vs(13.00±1.75) cm](P＜0.05);在术中失血量,术后通气时间及住院时间上手助腹腔镜组与开腹手术组相比差异有统计学意义 [(183.3±61.87)vs(242.5±105.08) mL;(3.12±0.73)vs(3.38±0.83) d;(7.83±1.56)vs(8.68±1.96) d](P＜0.05);细胞因子CRP、IL-6及COR在术前两组之间差异无统计学意义,术后第1天手助腹腔镜组的数值均明显低于开放手术组[(94.22±14.99)vs(101.81±18.66) mg·L-1;(35.83±4.12)vs(38.56±4.58) ng·L-1;(389.00±30.97)vs(406.61±36.89) μg·L-1](P＜0.05);而术后第3天差异无统计学意义。结论 手助腹腔镜手术治疗胃癌是安全可行的,其短期疗效与开放手术相当;且手助腹腔镜具有对机体干扰较小,术后胃肠道功能恢复更快的优势。 |
| 英文摘要: |
| Objective To investigate the short-term clinical evaluation of hand assisted laparoscopic surgery in the treatment of gastric cancer.Methods We selected gastric cancer patients who underwent HALS and OS at the gastrointestinal department of the First Affiliated Hospital of Anhui Medical University between January 2014 and March 2016.We collected serum from these patients preoperatively,1st day and 3rd day postoperatively to detect the levels of C-reactive protein(CRP),interleukin-6(IL-6) and cortisol(COR).Clinical indicators were also collected,including the patients′ basic information,underlying diseases and laboratory indexes,together with intraoperative parameters including operation time,incision length,blood loss,lymph node positive rate,tumor size and tumor stage, surgical methods and surgical properties,and also recovery time of postoperative gastrointestinal functions,postoperative complication occurrence rate and hospitalization time.Results Preoperative parameters of the two groups were not statistically different.Intraoperative lymph node positive rate,tumor size and tumor stage,surgical methods and surgical properties in HALS group and OS group were not statistically different (P>0.05);the length of incision in hand assisted laparoscopic group was shorter than that in OS group[(5.07±0.41)vs(13.00±1.75)cm] (P>0.05).Intraoperative blood loss,postoperative flatus time and hospitalization time in HALS group were superior to those in OS group [(183.3±61.87)vs(242.5±105.08) mL;(3.12±0.73)vs(3.38±0.83) d;(7.83±1.56)vs(8.68±1.96) d] (P<0.05);preoperative CRP,IL-6 and COR were not different between the two groups.In the first postoperative day,the levels of the three cytokines in HALS group were significantly lower than those in the OS group [(94.22±14.99)vs(101.81±18.66) mg·L-1;(35.83±4.12)vs(38.56±4.58) ng·L-1;(389.00±30.97)vs(406.61±36.89)μg·L-1] (P<0.05) while there was no statistical difference in the three cytokines levels between the two groups in the third postoperative day.Conclusions HALS is safe and feasible for patients with gastric cancer,which achieves the same short-term curative effect as OS.Compared with OS,HALS achieves faster recovery of gastrointestinal function and less stress interference. |
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