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中华普外科手术学杂志(电子版) ›› 2021, Vol. 15 ›› Issue (02) : 170 -173. doi: 10.3877/cma.j.issn.1674-3946.2021.02.015

所属专题: 文献

论著

腹腔镜下保留幽门及迷走神经胃切除术在早期胃癌患者的对照研究
夫尔多斯·阿马努拉1, 秦鹏1, 马尚智1, 王杰2, 刁红亮1,()   
  1. 1. 834000 克拉玛依市中心医院普外中心胃肠疝外科
    2. 844000 喀什地区第一人民医院
  • 收稿日期:2020-11-24 出版日期:2021-04-26
  • 通信作者: 刁红亮

A cohort study of laparoscopic pylorus and vagus nerve-preserving gastrectomy for patients with early gastric cancer

Amanula Fuerduosi1, Peng Qin1, Shangzhi Ma1, jie Wang2, Hongliang Diao1,()   

  1. 1. Department of gastrointestinal hernia surgery, general surgery center, Karamay Central Hospital, Xinjiang 834000, China
    2. Kashgar the first people's Hospital, Xinjiang 844000, China
  • Received:2020-11-24 Published:2021-04-26
  • Corresponding author: Hongliang Diao
  • Supported by:
    Natural Science Foundation of Xinjiang Uygur(201D01C1007)
引用本文:

夫尔多斯·阿马努拉, 秦鹏, 马尚智, 王杰, 刁红亮. 腹腔镜下保留幽门及迷走神经胃切除术在早期胃癌患者的对照研究[J/OL]. 中华普外科手术学杂志(电子版), 2021, 15(02): 170-173.

Amanula Fuerduosi, Peng Qin, Shangzhi Ma, jie Wang, Hongliang Diao. A cohort study of laparoscopic pylorus and vagus nerve-preserving gastrectomy for patients with early gastric cancer[J/OL]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2021, 15(02): 170-173.

目的

比较腹腔镜下保留幽门及迷走神经的胃切除术(LAPPG)与传统远端胃癌根治术(DG)治疗早期胃癌的安全性与近期手术效果。

方法

回顾性队列研究2018年3月至2019年5月100例早期胃癌患者临床资料,根据术式不同分为LAPPG组(44例)和DG组(56例)。采用SPSS 23.0统计分析软件,围术期指标、胆囊收缩率、患者自评-主观全面评定(PG-SGA)量表、消化道系统疾病生存质量指数表(GLQI)以(±s)表示,独立t检验;并发症用χ2检验。P<0.05为差异有统计学意义。

结果

LAPPG组手术时间长于DG组,术后首次排气及排便时间、胃排空时间、术后住院时间和术中出血量均短于/低于DG组(P<0.05);LAPPG组30 min胆囊收缩率比DG组低,45 min、60 min的胆囊收缩率比DG组高(P<0.05);LAPPG组术后6个月PG-SGA评分比DG组低,GLQI评分比DG组高(P<0.05);LAPPG组术后并发症发生率(9.1%)低于DG组(17.9%),但差异无统计学意义(P>0.05)。

结论

相比传统手术,LAPPG更利于提高早期胃癌患者的胃排空功能及胆囊收缩功能,改善营养状态及生活质量,加快术后康复进程,且并发症少,安全可靠。

Objective

To investigate the safety and short-term clinical outcome of laparoscopic pylorus and vagus nerve-preserving gastrectomy (LAPPG), compared with traditional distal gastrectomy (DG), in treating early gastric cancer.

Methods

A retrospective cohort study of 100 patients with early gastric cancer from March 2018 to May 2019 was performed. The patients were divided into LAPPG Group (44 cases) and DG Group (56 cases) . Statistical analysis were performed by using SPSS 23.0 software. Measurement data such as perioperative indicators, gallbladder contraction rate, PG-SGA scale, digestive system disease quality of life index table (Glqi) were expressed as (±s) and were analyzed by using independent t test. Complications were analyzed by using χ2 test. A P value of <0.05 is considered as statistically significant difference.

Results

The operation time in the LAPPG group was longer than that in the DG group, while the time of first exhaust and defecation, gastric emptying time, postoperative hospital stay, and intraoperative blood loss were shorter/lower than those in the DG group respectively (P<0.05). Compared with the DG group, there were higher gallbladder contraction rate at 30 min, however lower gallbladder contraction rate at 45min and 60min in the LAPPG group (P<0.05). The PG-SGA score of the LAPPG group was lower than that of the DG group at 6 months after surgery, and the GLQI score was higher than that of the DG group (P<0.05) . The postoperative complication rate of 9.1% in the LAPPG group was lower than 17.9% in the DG group, without statistically significant difference (P>0.05).

Conclusion

Compared with traditional DG, LAPPG is more conducive to improving the gastric emptying function and gallbladder contraction function of patients with early gastric cancer, improving the nutritional status and quality of life, and accelerating the postoperative rehabilitation process, with fewer complications, and it is safe and reliable.

表1 100例早期胃癌患者不同术式两组基线资料比较[(±s),例]
表2 100例早期胃癌患者不同术式两组围术期指标对比(±s)
表3 100例早期胃癌患者不同术式两组胆囊收缩率对比[±s),%]
表4 100例早期胃癌患者不同术式两组营养状态及生活质量比较[±s),分]
表5 100例早期胃癌患者不同术式两组术后并发症对比(例)
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