论文部分内容阅读
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 laparoscopic-assisted D2 radical gastrectomy for the prevention and treatment of gastric cancer. Methods 160 patients were randomly divided into experimental group and control group, 87 patients in the experimental group were treated with laparoscopic D2-assisted radical resection of gastric cancer, 73 patients in the control group were treated with open radical gastrectomy for D2 gastric cancer. Comparing two groups of patients with postoperative complications Symptoms, and their risk factors Logistic regression analysis. Results The operation time of the patients in the two groups was 121.5 ± 63.2 min and that of the lymph nodes was 29 ± 4. The operation time of the control group was 125.2 ± 54.5 min and the lymph nodes were 28 ± 3, Pieces, no significant difference between the two groups (P> 0.05). The blood loss (101.2 ± 28.9) ml, anal exhaust time (2.9 ± 6) days, hospital stay (7.2 ± 5.3) days, blood loss in the control group (152.5 ± 34.6) ml and anal Exhalation time (4.1 ± 1.1) d, hospital stay (13.1 ± 1.5) d, the difference between the two groups was statistically significant (P <0.05). There were 20 cases (23.0%) in the experimental group and 28 cases (38.4%) in the control group. There was significant difference in the complication rates between the two groups (P <0.05). Logistic regression analysis of postoperative complications showed that the risk factors of postoperative complications in all patients were smoking, alcohol drinking, tumor size and pathological type. The risk factors of smoking, drinking, tumor size and anastomosis of the patients in the experimental group were all risk factors. Conclusions Laparoscopic-assisted radical D2 surgery has the advantage of less invasiveness and less invasiveness. Poor patient habits, tumor status and surgical options have an impact on postoperative complications.