摘要
目的探讨全腹腔镜下远端胃切除术(TLDG)联合三角吻合术(DA)治疗胃癌的临床效果。方法选择75例胃癌患者,采用随机数表法将其分为对照组(n=38)和观察组(n=37),对照组给予LADG+管状吻合(TA)术式,观察组给予TLDG+DA术式。比较两组手术相关指标、免疫功能[免疫球蛋白M(IgM)、免疫球蛋白A(IgA)、免疫球蛋白G(IgG)]、术后并发症发生情况。结果两组淋巴结清扫数目相比,差异无统计学意义(P>0.05);观察组手术、肠蠕动恢复、住院时间均短于对照组,术中出血量少于对照组,差异有统计学意义(P<0.05);术后4 d两组IgA、IgG、IgM水平比术前低,观察组降低幅度更小,差异有统计学意义(P<0.05);观察组并发症发生率(8.11%)略低于对照组(21.05%),差异无统计学意义(P>0.05)。结论胃癌患者采用TLDG联合DA术治疗减轻手术创伤,加快术后恢复,对免疫功能影响小,且可降低术后并发症发生率。
Objective To investigate the clinical effect of total laparoscopic distal gastrectomy(TLDG)combined with delta-shaped anastomosis(DA)in the treatment of gastric cancer.Methods 75 patients with gastric cancer were selected,they were divided into the control group(n=38)and the observation group(n=37)by random number table method,the control group was given LADG+tubular anastomosis(TA)mode,and the observation group was given TLDG+DA mode.The operation related indexes,immune function[immunoglobulin M(IgM),immunoglobulin A(IGA),immunoglobulin G(IgG)]and postoperative complications were compared between the 2 groups.Results Compared the number of lymph node dissection between the 2 groups,the difference was not significant statistically(P>0.05);the operation time,intestinal peristalsis recovery time and hospitalization time of the observation group were shorter than the control group,and the intraoperative blood loss was less than the control group,the difference was significant statistically(P<0.05);the levels of IgA,IgG and IgM in the 2 groups 4 days after operation were lower than those before operation and the decrease range of the observation group was smaller,the difference was significant statistically(P<0.05);the incidence of complications in the observation group(8.11%)was slightly lower than the control group(21.05%),the difference was not significant statistically(P>0.05).Conclusion The combination of TLDG and DA can reduce surgical trauma in patients with gastric cancer,accelerate postoperative recovery,has little effect on immune function,and can reduce the incidence of postoperative complications.
作者
张一帆
ZHANG Yifan(Nanyang Second People’s Hospital,Nanyang,473000)
出处
《实用癌症杂志》
2021年第9期1521-1523,1527,共4页
The Practical Journal of Cancer
关键词
胃癌
全腹腔镜下远端胃切除术
三角吻合术
管状吻合术
免疫功能
Gastric cancer
Total laparoscopic distal gastrectomy
Delta-shaped anastomosis
Tubular anastomosis
Immune function
