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中华普外科手术学杂志(电子版) ›› 2022, Vol. 16 ›› Issue (03) : 295 -298. doi: 10.3877/cma.j.issn.1674-3946.2022.03.017

论著

腹型肥胖对胃癌患者腹腔镜远端胃癌根治术近期疗效的影响分析
朱智勇1,(), 马静2, 陈宜政1   
  1. 1. 833200 新疆伊犁,伊犁哈萨克自治州奎屯医院普外科
    2. 833200 新疆伊犁,伊犁哈萨克自治州奎屯医院麻醉科
  • 收稿日期:2021-03-01 出版日期:2022-04-26
  • 通信作者: 朱智勇

Effect of abdominal obesity on the short-term efficacy of laparoscopic distal gastrectomy for gastric cancer

Zhiyong Zhu1,(), Jing Ma2, Yizheng Chen1   

  1. 1. Department of General Surgery,Kuitun Hospital Yili Kazakh Autonomous Prefecture,Yili Xinjiang Uygur Autonomous Region 833200,China
    2. Department of Anesthesiology,Kuitun Hospital Yili Kazakh Autonomous Prefecture,Yili Xinjiang Uygur Autonomous Region 833200,China
  • Received:2021-03-01 Published:2022-04-26
  • Corresponding author: Zhiyong Zhu
引用本文:

朱智勇, 马静, 陈宜政. 腹型肥胖对胃癌患者腹腔镜远端胃癌根治术近期疗效的影响分析[J/OL]. 中华普外科手术学杂志(电子版), 2022, 16(03): 295-298.

Zhiyong Zhu, Jing Ma, Yizheng Chen. Effect of abdominal obesity on the short-term efficacy of laparoscopic distal gastrectomy for gastric cancer[J/OL]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2022, 16(03): 295-298.

目的

分析腹型肥胖对胃癌患者腹腔镜远端胃癌根治术近期疗效的影响。

方法

回顾性分析2016年1月至2017年12月腹腔镜远端胃癌根治术治疗的100例胃癌患者临床资料,依据身体质量指数(BMI)分为肥胖组(≥25 kg/m2n=40例)和正常组(<25 kg/m2n=60例),采用SPSS 25.0统计软件处理数据,围手术期各项指标等计量资料采用(

xˉ
±s)表示,独立样本t检验;并发症发生率等计数资料采用[n(%)]表示,行χ2检验。P<0.05表示差异有统计学意义。

结果

肥胖组患者手术用时长于正常组,术中出血量多于正常组,淋巴结清扫枚数少于正常组(P<0.05);肥胖组患者术后并发症发生率42.5%、复发率12.5%,均大于对照组10.0%、3.3%(P<0.05);肥胖组患者无病生存率62.5%、总生存率75.0%,正常组为63.3%、78.3%,两组差异无统计学意义(P>0.05)。肥胖组患者复发率12.5%,大于正常组3.3%,两组差异有统计学意义(P<0.05)。

结论

腹型肥胖对胃癌患者腹腔镜远端胃癌根治术疗效具有一定影响且会加大术后并发症发生以及复发风险。

Objective

To analyze the effect of abdominal obesity on the curative effect of gastric cancer patients with laparoscopic distal gastric cancer radical resection.

Methods

The clinical data of 100 patients with gastric cancer who underwent laparoscopic distal gastric cancer radical resection from January 2016 to December 2017 were retrospectively analyzed. They were divided into obese group(≥25 kg/m2n=40 cases)and normal group based on BMI(<25 kg/m2n=60 cases),SPSS 25.0 statistical software was used for data processing. Perioperative indicators and other measurement data were expressed by(

xˉ
±s),independent t test was performed. The isometric data of complication rate was expressed by[n(%)],and P<0.05 was statistically significant by χ2 test.

Results

The operation time of the obese group was longer than that of the normal group,the blood loss was more than that of the normal group,and the number of lymph node dissections was less than that of the normal group(P<0.05). The incidence of postoperative complications and recurrence in obesity group were 42.5% and 12.5%,respectively,higher than those in control group(10.0% and 3.3%,P<0.05). The disease-free survival rate was 62.5%,and the overall survival rate was 75.0% in the obese group,and the normal group was 63.3%,78.3%. There was no statistically significant difference between the two groups(P>0.05). The recurrence rate of obese group was 12.5%,which was higher than that of normal group by 3.3%,and the difference was statistically significant(P<0.05).

Conclusion

Abdominal obesity has a certain impact on the efficacy of laparoscopic distal radical gastrectomyfor gastric cancer patients and will increase the risk of complications and recurrence.

表1 100例腹腔镜远端胃癌根治术肥胖组与正常组患者一般资料对比[(
xˉ
±s),例]
表2 100例腹腔镜远端胃癌根治术肥胖组与正常组患者围手术期指标对比(
xˉ
±s)
表3 100例腹腔镜远端胃癌根治术肥胖组与正常组患者术后康复指标对比[(
xˉ
±s),d]
表4 100例腹腔镜远端胃癌根治术肥胖组与正常组患者术后并发症发生率对比[例(%)]
表5 100例腹腔镜远端胃癌根治术肥胖组与正常组患者术后3年随访结果[例(%)]
图1 100例腹腔镜远端胃癌根治术肥胖组与正常组患者术后3年生存曲线
[1]
李彬,刘牧林,彭欣元,等. 皖北地区胃癌患者致病因素及复发风险预警研究[J]. 广州医科大学学报201947(6):52-56.
[2]
Beeharry MKZhang TQLiu WT,et al. Optimization of perioperative approaches for advanced and late stages of gastric cancer:clinical proposal based on literature evidence,personal experience,and ongoing trials and research[J]. World J Surg Oncol202018(1):51.
[3]
赵云,邓仲鸣. 手助腹腔镜与腹腔镜辅助远端胃癌根治术在进展期胃癌中的临床效果对比研究[J/CD].中华普外科手术学杂志(电子版)202014(1):81-85.
[4]
林和新,燕速,叶志坚,等. 体型对腹腔镜远端胃癌根治术后近期疗效的多中心回顾性研究(附506例报告)[J]. 中华消化外科杂志201918(1):65-73.
[5]
蒋大平,徐华平,方华进,等. 影响胃癌根治术后患者预后效果的相关因素分析[J]. 中国现代医学杂志202030(4):39-43.
[6]
李立新,蔡翠芳,李文祥,等. 胃癌根治术预后相关因素的研究[J]. 分子诊断与治疗杂志202012(8):1001-1004.
[7]
李国新,陈新华,余江,等. 中国、日本和韩国腹腔镜胃癌外科临床研究现状[J]. 中华胃肠外科杂志201821(2):126-131.
[8]
李国新,刘浩. 胃癌微创外科临床研究进展及展望(2000-2020)[J]. 中国实用外科杂志202040(1):62-64,69.
[9]
Diniz TPda Costa Jr WLFonseca de Jesus VH,et al. Does hipec improve outcomes in gastric cancer patients treated with perioperative chemotherapy and radical surgery?A propensity-score matched analysis[J]. J Surg Oncol2020121(5):823-832.
[10]
李敏娜,路宁,王艺璇,等. 中青年与老年胃癌术后患者的临床病理特点和预后因素—基于SEER数据库的分析[J]. 现代肿瘤医学202028(14):2467-2473.
[11]
蔡明,曾祥宇,熊振,等. 腹腔镜胃癌D2根治术后早期并发症及其影响因素[J]. 中华胃肠外科杂志201922(8):742-747.
[12]
王腾,金琳芳,华东. 临床分期高于病理分期的偏倚影响胃癌根治术后患者预后的临床观察[J]. 临床肿瘤学杂志201924(12):1119-1123.
[13]
杨修伟,王刚,陆峰,等. 腹部体型参数对腹腔镜远端胃癌D2根治术围术期并发症及术后恢复的影响[J]. 临床外科杂志202028(7):650-653.
[14]
季加孚,王宇宸,肖琪严. 中国胃癌腹腔镜手术临床研究现状[J/CD]. 中华普外科手术学杂志(电子版)201913(2):109-113.
[15]
何裕隆. 腹腔镜根治手术在胃癌中应用的现状与争议[J/CD]. 中华普外科手术学杂志(电子版)201913(2):114-120.
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