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目的探讨腹部形态的CT测量与胃癌患者的短期手术结局的关系。方法回顾性收集2008年5月—2009年9月在上海交通大学医学院附属瑞金医院普外科病房接受经腹胃切除+D2淋巴结清扫术的226例胃癌患者的临床资料。患者在手术前通过CT扫描分别测量腹部前后径(APD)和腹部横径(TD)。按APD值将患者分为高APD组(APD≥18.5 cm)和低APD组(APD<18.5 cm);按TD值将患者分为高TD组(TD≥30 cm)和低TD组(TD<30 cm)。记录患者术中出血量、手术时间、术后住院天数、术后胃周淋巴结剥出个数及术后早期并发症情况,并进行组间比较。结果高APD组与低APD组及高TD组与低TD组患者的手术时间、术中出血量、中位淋巴结检出个数的差异均无统计学意义(P值均>0.05)。27例患者出现术后早期并发症,高APD组与低APD组间及高TD组与低TD组间并发症发生率的差异均无统计学意义(P值均>0.05)。结论 CT测量指标APD及TD均不影响胃癌患者的手术时间、出血量、住院天数、淋巴结检出数及早期术后并发症发生率。
Objective To investigate the relationship between abdominal CT measurement and short-term surgical outcomes in patients with gastric cancer. Methods We retrospectively collected the clinical data of 226 patients with gastric cancer undergoing transabdominal gastrectomy plus D2 lymph node dissection from May 2008 to September 2009 in the General Surgery ward of Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine. Patients underwent CT scan before surgery to measure anteroposterior diameter (APD) and abdominal transverse diameter (TD), respectively. Patients were divided into high APD group (APD> 18.5 cm) and low APD group (APD <18.5 cm) by APD value. Patients were divided into high TD group (TD≥30 cm) and low TD group (TD < 30 cm). The amount of intraoperative blood loss, operation time, hospital stay, number of postoperative lymphadenectasis and early postoperative complications were recorded and compared between groups. Results There were no significant differences in operative time, intraoperative blood loss and the number of detected lymph nodes between high APD group and low APD group and between high TD group and low TD group (all P> 0.05). There were no significant differences in the incidence of complications between the high APD group and the low APD group, the high TD group and the low TD group (P> 0.05). Conclusion Both APD and TD did not affect the operation time, blood loss, days of hospitalization, the number of lymph nodes and the incidence of early postoperative complications in patients with gastric cancer.