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目的比较传统解剖法和刮吸解剖法在进展期胃癌和大肠癌(简称胃肠癌)淋巴结清扫术中的效率。方法皖南医学院弋矶山医院2004年1月至2007年8月将收治的97例进展期胃肠癌病人随机分为传统手术组和刮吸手术组,分别统计两组手术时间、出血量、输血量、清除淋巴结数和术后随访情况。结果传统手术组和刮吸手术组平均手术时间分别为203.62min和209.60min;两组平均出血量分别为330.64mL和245.00mL,输血者平均输血量分别为683.33mL和504.50mL;平均每例清除淋巴结数分别为11.60枚和17.48枚。两组分别有39例和41例得到平均3年的随访,肿瘤复发率分别为48.72%和26.83%,3年存活率分别为56.41%和75.61%。结论刮吸解剖法可提高进展期胃肠癌淋巴结清扫程度和清扫效率,减少出血量;并降低肿瘤复发率,延长病人生存时间。刮吸法淋巴结清扫应掌握多功能手术解剖器的结构特点及其操作技巧。
Objective To compare the efficiency of traditional anatomy and scraping anatomy in lymph node dissection of advanced gastric cancer and colorectal cancer (referred to as gastrointestinal cancer). Methods Ninety-nine patients with advanced gastrointestinal cancer admitted from January 2004 to August 2007 in Yijishan Hospital of Wannan Medical College were randomly divided into traditional operation group and shaving suction operation group. The operation time, blood loss, Blood transfusion, lymph node clearance and postoperative follow-up. Results The average operative time was 203.62min and 209.60min respectively in the traditional operation group and the shaving operation group. The mean blood loss in the two groups were 330.64mL and 245.00mL, respectively. The average blood transfusion volume of transfusion recipients was 683.33mL and 504.50mL respectively. The number of lymph nodes were 11.60 and 17.48, respectively. In both groups, 39 cases and 41 cases were followed up for an average of 3 years. The tumor recurrence rates were 48.72% and 26.83% respectively. The 3-year survival rates were 56.41% and 75.61% respectively. Conclusion Scratch-suction anatomy can improve lymphadenectomy and dissection efficiency, reduce the amount of bleeding, reduce the recurrence rate and extend the survival time of patients with advanced gastrointestinal cancer. Shaving suction lymph node dissection should grasp the structural features of multifunctional surgical dissector and its operating skills.