胃体悬吊法在腹腔镜胃癌根治术胰腺上区淋巴结清扫中的应用价值

Application value of gastric suspension method in supra-pancreatic lymph node dissection of laparoscopic radical gastrectomy of gastric cancer

    摘要
  • 摘要:
    目的 探讨胃体悬吊法在腹腔镜胃癌根治术胰腺上区淋巴结清扫中的应用价值。
    方法 采用回顾性队列研究方法。收集2023年8月至2024年7月浙江省肿瘤医院收治的84例行腹腔镜胃癌根治术患者的临床病理资料；男61例，女23例；年龄为（64±11）岁。84例患者中，42例腹腔镜胃癌根治术中胰腺上区淋巴结清扫手术区域暴露采用传统方法，设为对照组；42例腹腔镜胃癌根治术中胰腺上区淋巴结清扫手术区域暴露采用胃体悬吊法，设为悬吊组。观察指标：（1）手术情况。（2）术后情况。正态分布的计量资料组间比较采用独立样本t检验；偏态分布的计量资料组间比较采用Mann-Whitney U检验。计数资料组间比较采用χ²检验。
    结果 （1）手术情况。对照组患者胰腺上区淋巴结清扫时间、抓持次数、抓持出血位置数目、手术时间分别为（78±14）min、（116±34）次、（7.8±2.7）个、（3.9±0.8）h，悬吊组患者上述指标分别为（59±12）min、（68±19）次、（2.1±1.5）个、（3.3±0.7）h，两组患者上述指标比较，差异均有统计学意义（t=5.42、8.10、8.31、3.14，P < 0.05）。（2）术后情况。对照组和悬吊组患者肿瘤长径分别为2.5（2.0，3.5）cm和3.0（2.4，4.4）cm，两组比较，差异有统计学意义（Z=-1.98，P < 0.05）。
    结论 与传统未悬吊胃体比较，腹腔镜胃癌根治术中采用胃体悬吊法行胰腺上区淋巴结清扫耗时更短、创伤更小。

     

    Abstract:
    Objective To investigate the application value of gastric suspension method in supra-pancreatic lymph node dissection of laparoscopic radical gastrectomy of gastric cancer.
    Method The retrospective cohort study was conducted. The clinicopathological data of 84 patients who under-went laparoscopic radical gastrectomy of gastric cancer at Zhejiang Cancer Hospital from August 2023 to July 2024 were collected. There were 61 males and 23 females, aged (64±11)years. Of the 84 patients, 42 patients undergoing supra-pancreatic lymph node dissection during laparoscopic radical gastrectomy of gastric cancer with traditional method for surgical field exposure were divided into the control group, and 42 patients undergoing supra-pancreatic lymph node dissection during laparoscopic radical gastrectomy of gastric cancer with gastric suspension method for surgical field exposure were divided into the suspension group. Observation indicators: (1) surgical conditions; (2) postoperative conditions. Comparison of measurement data with normal distribution between groups was conducted using the independent sample t test. Comparison of measurement data with skewed distribution between groups was conducted using the Mann-Whitney U test. Comparison of count data between groups was conducted using the chi-square test.
    Results (1) Surgical condi-tions. The time for supra-pancreatic lymph node dissection of the control group was (78±14)minutes. Number of grasping operations was 116±34, number of bleeding sites caused by grasping operations was 7.8±2.7, and operation time was (3.9±0.8)hours. The above indicators of the suspension group were (59±12)minutes, 68±19, 2.1±1.5, and (3.3±0.7)hours, respectively. There were significant diffe-rences in the above indicators between the two groups (t=5.42, 8.10, 8.31, 3.14, P < 0.05). (2) Post-operative conditions. The tumor diameter was 2.5(2.0, 3.5)cm for patients of the control group, versus 3.0(2.4, 4.4)cm for patients of the suspension group, showing a significant difference between the two groups (Z=-1.98, P < 0.05).
    Conclusion Compared with the traditional non-suspension method, the gastric suspension method in laparoscopic radical gastrectomy of gastric cancer for supra-pancreatic lymph node dissection is associated with shorter operation time and less trauma.

     

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