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中华普外科手术学杂志(电子版) ›› 2020, Vol. 14 ›› Issue (06) : 566 -568. doi: 10.3877/cma.j.issn.1674-3946.2020.06.010

所属专题: 文献

论著

早期胃癌患者腹腔镜胃癌根治术后复发相关因素分析
张伟1,(), 蔡振花2   
  1. 1. 056001 邯郸市中心医院普外二科
    2. 056001 邯郸市中心医院手术室
  • 收稿日期:2020-01-20 出版日期:2020-12-26
  • 通信作者: 张伟

Clinical factors and prognosis of recurrence of laparoscopic radical gastrectomy in patients with early gastric cancer

Wei Zhang1,(), Zhenhua Cai2   

  1. 1. Yandan center hospital, General Branch, Yandan Hebei 056001
    2. Yandan center hospital, operating room, Yandan Hebei 056001
  • Received:2020-01-20 Published:2020-12-26
  • Corresponding author: Wei Zhang
  • About author:
    Corresponding author: Zhang Wei, Email:
  • Supported by:
    Hebei Medical Science Research Project(20191831)
引用本文:

张伟, 蔡振花. 早期胃癌患者腹腔镜胃癌根治术后复发相关因素分析[J/OL]. 中华普外科手术学杂志(电子版), 2020, 14(06): 566-568.

Wei Zhang, Zhenhua Cai. Clinical factors and prognosis of recurrence of laparoscopic radical gastrectomy in patients with early gastric cancer[J/OL]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2020, 14(06): 566-568.

目的

分析早期胃癌患者腹腔镜胃癌根治术后复发的相关临床因素及预后。

方法

回顾性分析2012年3月至2016年3月收治的胃癌患者100例,根据手术方法的不同分组,分为开腹组(50例,开放式胃癌切除术治疗)、腹腔镜组(50例,腹腔镜胃癌根治术治疗),运用SPSS 26.0进行统计学分析,两组术后1年、2年、3年复发率采用以χ2检验;手术情况、VAS及GLQI评分等计量资料以(±s)表示,独立t检验,Logistic分析术后复发危险因素,P<0.05差异有统计学意义。

结果

腹腔镜组手术时间、切口长度、住院时间明显比开腹组短,腹腔镜组术中出血量、VAS评分明显比开腹组低,腹腔镜组GLQI评分明显比开腹组高;1年、2年、3年复发率比较,腹腔镜组(8.0%、14.0%、26.0%)与开腹组(12.0%、20.0%、34.0%)比较两组差异无统计学意义(P>0.05)。年龄、肿瘤直径、术后是否化疗、TNM分期是影响腹腔镜胃癌根治术术后复发独立危险因素,P<0.05。

结论

腹腔镜胃癌根治术在胃癌治疗中可显著缩短患者治疗时间,减轻患者疼痛感。年龄、肿瘤直径、术后是否化疗、TNM分期是导致胃癌患者术后复发的独立危险因素,应当引起临床重视。

Objective

To analyze the clinical factors and prognosis of patients with early gastric cancer after laparoscopic radical resection.

Methods

100 patients with gastric cancer admitted to our hospital from March 2012 to March 2016 were divided into open group (50 cases, treated with open gastric cancer resection) and laparoscopic group (50 cases) according to different surgical methods. The laparoscopic radical gastrectomy was performed. The recurrence rate, VAQ score, GLQI score, 1 year, 2 years, and 3 years recurrence rate were compared between the two groups. Logistic analysis of risk factors for recurrence after laparoscopic radical gastrectomy.

Results

In the laparoscopic group, the operation time, length of incision, and length of hospital stay were significantly shorter than those in the open group. The amount of bleeding and VAS in the laparoscopic group were significantly lower than those in the open group. The GLQI score in the laparoscopic group was significantly higher than that in the open group. The 2-year and 3-year recurrence rates of the laparoscopic group (8.00%, 14.00%, 26.00%) were compared with the open group (12.00%, 20.00%, 34.00%) P>0.05. Age, tumor diameter, postoperative chemotherapy, and TNM staging were the risk factors for recurrence after laparoscopic radical gastrectomy (P<0.05).

Conclusion

Laparoscopic radical gastrectomy in patients with early gastric cancer can significantly shorten the treatment time, reduce the pain and reduce the recurrence rate in patients with gastric cancer. However, age, tumor diameter, postoperative chemotherapy, and TNM staging are important factors leading to postoperative disease recurrence in patients undergoing laparoscopic radical gastrectomy.

表1 100例胃癌患者不同术式两组患者基本资料比较[(±s),例]
表2 100例胃癌患者不同术式两组患者手术情况比较(±s)
表3 100例胃癌患者不同术式两组患者1~3年复发率和VAS评分、GLQI评分[(±s),分]
表4 13例早期胃癌腹腔镜胃癌根治术术后复发单因素分析(例)
表5 早期胃癌腹腔镜胃癌根治术术后复发多因素分析
[1]
徐卫国,徐华,马君俊,等.腹腔镜辅助胃癌根治术后并发症的Clavien-Dindo分级及危险因素分析[J].中华消化外科杂志,2016, 15(3): 228-233.
[2]
马俊文,马文,韩瑞东.腹腔镜辅助胃癌根治术的临床应用效果及对患者血清学指标的影响[J].中国普通外科杂志,2018, 27(4): 518-522.
[3]
所剑.第5版日本《胃癌治疗指南》更新要点[J].中国实用外科杂志,2017, 37(4): 78-81.
[4]
蒋光富,姜明,陈尚武.腹腔镜胃癌根治术后胃肠功能及凝血功能的变化分析[J]. 中国现代普通外科进展,2018, 21(9): 726-728.
[5]
余稳稳,陶瑞雨,闫开旭,等.腹腔镜下远端胃癌根治术后患者早期经口进食的临床研究[J].中国普外基础与临床杂志,2016, 23(11): 1339-1343.
[6]
张永康,黄华俊.腹腔镜胃癌根治术对老年胃癌患者的临床疗效的影响[J].实用癌症杂志,2016, 31(10): 1662-1664, 1668.
[7]
蒋晖,杜军,顾纪明,等.腹腔镜胃癌根治术与开腹胃癌根治术治疗老年胃癌疗效比较[J].新乡医学院学报,2016, 33(9): 770-773.
[8]
Xie XS, Lin JX, Li P,et al.A risk prediction system of postoperative hemorrhage following laparoscopy-assisted radical gastrectomy with D2 lymphadenectomy for primary gastric cancer[J]. Oncotarget,2017, 8(46): 81511-81519.
[9]
江华勇,蒋宗明,郑羡河,等.加速康复外科策略对腹腔镜胃癌根治术老年患者术后早期认知功能和术后恢复的影响[J].中华全科医学,2018, 16(9): 1452-1454, 1578.
[10]
张军,蔡军.全程使用LigaSure完成腹腔镜下胃癌根治术D2淋巴结清扫[J/CD].中华普外科手术学杂志(电子版), 2017, 11(6): 465.
[11]
张佳宇,宋彬,高硕徽,等.胃癌患者腹腔镜胃癌根治术后感染病原菌分布及危险因素分析[J].中国实验诊断学,2016, 20(9): 1474-1476
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