脐上或脐下观察孔在腹腔镜远端胃癌根治性切除术中的选择
The choice of supraumbilical or subumbilical observation port in laparoscopic radical gastrectomy for distal gastric cancer
邢智远 1张凤娟 2谭晓杰 3江海涛3
作者信息
- 1. 康复大学青岛中心医院腹部肿瘤外科,山东 青岛,266042
- 2. 青岛大学附属医院感染科
- 3. 青岛大学附属医院胃肠外科
- 折叠
摘要
目的:比较脐上与脐下观察孔位置在腹腔镜远端胃癌根治术中的临床应用效果.方法:回顾分析 2021 年 1 月至2023 年10 月为71 例患者行腹腔镜远端胃癌根治术的临床资料.根据观察孔位置分为脐上组(n=37)与脐下组(n=34).对比分析两组手术切皮至淋巴结清扫完成时间、术中出血量、淋巴结清扫数量、术后早期并发症发生率及术后住院时间,手术均由同一团队完成.结果:两组患者均顺利完成手术,无中转开腹及严重并发症发生.脐上组切皮至淋巴结清扫完成时间短于脐下组[(118.8±5.2)min vs.(140.6±8.4)min,P<0.05],术中出血量少于脐下组[(29.7±6.2)mL vs.(32.7±5.5)mL,P<0.05],淋巴结清扫数量多于脐下组[(35.4±5.2)枚 vs.(32.7±5.5)枚,P<0.05].脐上组与脐下组术后住院时间[(6.7±1.2)d vs.(6.8±1.3)d,P>0.05]、并发症总发生率[10.8%(4/37)vs.14.7%(5/34)]差异无统计学意义.结论:腹腔镜远端胃癌根治术中选择脐上观察孔具有更好的手术视野,更容易显露胰腺上缘左右区域,在清扫胰腺上缘左右区域淋巴结时更具优势,手术效果更好.
Abstract
Objective:To compare the clinical effects of supraumbilical and subumbilical observation port positions in laparo-scopic radical gastrectomy for distal gastric cancer.Methods:The clinical data of 71 patients who underwent laparoscopic distal gastrec-tomy for gastric cancer from Jan.2021 to Oct.2023 were retrospectively analyzed.According to the location of the observation port du-ring operation,the patients were divided into two groups:supraumbilical group(n=37)and subumbilical group(n=34).The time from skin incision to lymph node dissection,intraoperative blood loss,number of lymph node dissection,incidence of early postoperative com-plications and postoperative hospital stay were compared between the two groups.Both groups,operations were performed by the same physician team.Results:The surgery was successfully completed in both groups,and there was no conversion to open operation or seri-ous intraoperative complications.The time from skin incision to lymph node dissection in the supraumbilical group was shorter than that in the subumbilical group[(118.8±5.2)min vs.(140.6±8.4)min,P<0.05].The intraoperative blood loss in the supraumbilical group was significantly less than that in the subumbilical group[(29.7±6.2)mL vs.(32.7±5.5)mL,P<0.05].The number of lymph node dissection in the supraumbilical group was significantly higher than that in the subumbilical group[(35.4±5.2)vs.(32.7±5.5),P<0.05].There was no significant difference in postoperative hospital stay[(6.7±1.2)d vs.(6.8±1.3)d,P>0.05]and total incidence of complications[10.8%(4/37)vs.14.7%(5/34)]between the two groups.Conclusions:The selection of supraumbilical observation port in laparoscopic distal gastrectomy for gastric cancer has better surgical field,easier exposure of the left and right area at upper edge of the pancreas,and has more advantages in the lymph node excision of the left and right area at upper edge of the pancreas,and the surgical effect is better.
关键词
胃肿瘤/远端胃癌根治术/腹腔镜检查/淋巴结切除术/观察孔Key words
Stomach neoplasms/Radical distal gastrectomy/Laparoscopy/Lymph node excision/Observation port引用本文复制引用
出版年
2024
国家科技期刊平台
NSTL
万方数据