腹腔镜远端胃癌D2根治术对原发性胃癌患者术后炎症状态及预后的影响OA
Effect of Laparoscopic Distal D2 Radical Gastrectomy on Postoperative Inflammatory Status and Prognosis in Patients with Primary Gastric Cancer
目的 探讨腹腔镜远端胃癌D2根治术对原发性胃癌患者术后早期炎症状态及预后的影响.方法 选取2019年8月至2024年5月东莞市人民医院普济院区收治的120例原发性胃癌患者为研究对象,采用随机数表法分为腹腔镜组(60例)和开腹组(60例).腹腔镜组行腹腔镜远端胃癌D2根治术,开腹组行传统开腹远端胃癌D2根治术.比较两组术中出血量、手术时间、术后首次通气时间、术后住院时间、淋巴结清扫数目、近切端距肿瘤距离、远切端距肿瘤距离、炎症指标[C反应蛋白(CRP)、降钙素原(PCT)、白细胞计数(WBC)]、并发症及术后1年预后情况.结果 两组手术时间、淋巴结清扫数目、近切端距肿瘤距离、远切端距肿瘤距离比较,差异均无统计学意义(P>0.05).腹腔镜组术中出血量、术后首次通气时间及住院时间少于开腹组(P<0.05),并发症发生率低于对照组(P<0.05).术后第3天,腹腔镜组CRP、PCT和WBC水平低于开腹组(P<0.05).术后1年,两组患者生存率及术后肿瘤复发率比较,差异均无统计学意义(P>0.05).结论 腹腔镜远端胃癌D2根治术治疗原发性胃癌,能显著减少术中出血量,促进术后康复,减轻机体炎症反应,同时降低并发症风险.
Objective To investigate the effect of laparoscopic distal D2 radical gastrectomy on early postoperative inflammatory status and prognosis in patients with primary gastric cancer.Methods A total of 120 patients with primary gastric cancer admitted to the Puji Branch of Dongguan People's Hospital from August 2019 to May 2024 were selected as study subjects and randomly divided into a laparoscopic group(n=60)and an open surgery group(n=60)using a random number table.The laparoscopic group underwent laparoscopic distal D2 radical gastrectomy,while the open surgery group received traditional open distal D2 radical gastrectomy.The two groups were compared in terms of intraoperative blood loss,operative time,time to first flatus,postoperative hospital stay,number of lymph nodes dissected,distance from proximal resection margin to tumor,distance from distal resection margin to tumor,inflammatory markers[C-reactive protein(CRP),procalcitonin(PCT),white blood cell(WBC)count],complications,and 1-year postoperative prognosis.Results No statistically significant differences were observed between the two groups in operative time,number of lymph nodes dissected,distance from proximal resection margin to tumor,or distance from distal resection margin to tumor(P>0.05).Compared with the open surgery group,the laparoscopic group had less intraoperative blood loss,shorter time to first flatus,and shorter postoperative hospital stay(P<0.05),and the incidence of complications was lower(P<0.05).On postoperative day 3,the levels of CRP,PCT,and WBC in the laparoscopic group were significantly lower than those in the open surgery group(P<0.05).At 1 year after surgery,there were no significant differences in survival rate or tumor recurrence rate between the two groups(P>0.05).Conclusion Laparoscopic distal D2 radical gastrectomy for primary gastric cancer can significantly reduce intraoperative blood loss,promote postoperative recovery,alleviate the systemic inflammatory response,and lower the risk of complications.
李丽华;张丽萍;李庆贤;吕嘉慧;谢顺玲;刘淑娟;叶爱珍
东莞市人民医院普济院区胃肠外科,广东 东莞 523000东莞市人民医院科教处,广东 东莞 523000东莞市人民医院普济院区胃肠外科,广东 东莞 523000东莞市人民医院普济院区胃肠外科,广东 东莞 523000东莞市人民医院普济院区胃肠外科,广东 东莞 523000东莞市人民医院普济院区胃肠外科,广东 东莞 523000东莞市人民医院普济院区外科,广东 东莞 523000
胃癌腹腔镜远端胃癌D2根治术炎症反应预后
gastric cancerlaparoscopylaparoscopic distal D2 radical gastrectomyinflammatory responseprognosis
《转化医学杂志》 2026 (5)
776-780,5
东莞市科技计划项目(20211800903232)
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