摘要
目的探讨腹腔镜辅助胃癌D2根治术并发症的危险因素,为其防治积累经验。方法 160例患者随机分为试验组和对照组,试验组87例患者采用腹腔镜辅助胃癌D2根治术,对照组73例患者采用开腹全胃切除胃癌D2根治术,比较两组患者术后并发症,并对其危险因素进行Logistic回归分析。结果两组患者手术情况比较,试验组患者手术操作时间(121.5±63.2)min,清扫淋巴结(29±4)枚;对照组患者手术操作时间(125.2±54.5)min,清扫淋巴结(28±3)枚,两组比较差异无统计学意义(P>0.05)。试验组患者术中出血量(101.2±28.9)ml、肛门排气时间(2.9±.6)d、住院时间(7.2±5.3)d,对照组患者术中出血量(152.5±34.6)ml、肛门排气时间(4.1±1.1)d、住院时间(13.1±1.5)d,两组比较差异有统计学意义(P<0.05)。试验组患者出现并发症20例(23.0%),对照组患者出现并发症28例(38.4%),两组患者并发症发生率差异有统计学意义(P<0.05)。术后并发症多因素Logistic回归分析显示,全部患者出现术后并发症的危险因素为吸烟、饮酒、肿瘤大小和病理分型;试验组患者的危险因素为吸烟、饮酒、肿瘤大小和吻合方式。结论腹腔镜辅助胃癌D2根治术创伤小,具有明显微创优势。患者不良生活习惯、肿瘤状态和手术方式的选择对术后并发症有影响。
Objective To explore the risk factors of laparoscopy-assisted D2 radical total gastrecto- my for gastric cancer complications. Methods 160 patients were collected, 87 patients in the observation group were treated with laparoscopy-assisted D2 radical total gastrectomy, 73 patients in the control group were treated with open D2 total gastrectomy, the complications were compared and the risk factors were ana- lyzed with Logistic regression analysis. Results Operation time was （ 121.5 -＋ 63.2） min andlymph node dissection was （29 ＋ 4） in observation group, （125.2 ＋ 54. 5）min and （28 -＋ 3） in the control group, the difference between the two groups was not statistically significant （P 〉 0. 05 ） ; blood loss was （ 101.2 -＋ 28.9） ml, anal exhaust time was （2. 9 ＋. 6） d, the hospitalization time was （7.2 ＋ 5.3 ） d in observation group, （ 152. 5 -＋ 34. 6） ml, （4. 1 ＋- 1.1 ） d, and （ 13. 1 ＋ 1.5） d in the control group, there was signifi- cant difference between two groups （P 〈 0. 05 ） ; there were 20 cases of complications （23.0%） in the ob- servation group, 28 patients with complications （38.4%） in the control group, the complication rate was statistically significant （ P 〈 0. 05 ） ; multivariate Logistic regression analysis of postoperative complications showed that to all the patients, risk factors were drinking, smoking, tumor size and histological type ; for patients in the observation group, risk factors were drinking, smoking, tumor size and consistent manner. Conclusions Laparoscopy-assisted D2 radical total gastrectomy for gastric cancer has obvious advantage of minimally invasive compared with open D2 total gastrectomy, patients with bad habits, tumor status and op- eration mode has effects on the postoperative complications.
出处
《中国肿瘤临床与康复》
2014年第3期267-269,共3页
Chinese Journal of Clinical Oncology and Rehabilitation
关键词
腹腔镜
胃肿瘤
并发症
Laparoscopy
Gastric neoplasms
Complication
