3D腹腔镜在老年患者远端胃癌根治术中应用的疗效与安全性

Efficacy and safety of 3D laparoscopy in radical resection of distal gastric cancer in the elderly patients

摘要:

目的 探讨3D腹腔镜在老年患者远端胃癌根治术中的疗效与安全性。方法 回顾性分析2018年5月－2020年5月该院64例老年远端胃癌患者的临床资料，根据不同手术方式分为对照组（n = 32）和观察组（n = 32），对照组使用开腹远端胃癌根治术，观察组使用3D腹腔镜远端胃癌根治术。对比两组患者手术相关指标、术后恢复效果、炎症状态、血浆胃肠激素相关指标和并发症发生率。结果 观察组术中出血量少于对照组，术后恢复效果优于对照组，白细胞（WBC）、C反应蛋白（CRP）、生长激素（SST）和血管活性肠肽（VIP）水平低于对照组，胃动素（MTL）高于对照组，两组患者比较，差异均有统计学意义（P < 0.05）；观察组并发症发生率低于对照组，但两组患者比较，差异无统计学意义（P > 0.05）。结论 3D腹腔镜能够明显改善老年远端胃癌患者的临床相关指标、术后恢复指标、炎症状态及血浆胃肠激素相关指标，且有助于降低并发症发生率，值得临床推广应用。

Abstract:

Objective To investigate the efficacy and safety of 3D laparoscopy in radical resection of distal gastric cancer in the elderly patients.Methods Clinical data of 64 elderly patients with distal gastric cancer in our hospital from May 2018 to May 2020 were retrospectively analyzed, according to the operation methods of the patients, there were 32 cases in the control group and 32 cases in the observation group, the control group used open distal gastric cancer radical resection, the observation group used 3D laparoscopic distal gastric cancer radical resection. The two groups were compared with surgical indicators, postoperative recovery effects, inflammation status, plasma gastrin-related indicators and complications rate.Results The amount of intraoperative bleeding in the observation group was less than that in the control group, and the postoperative recovery effect was better than that in the control group. The white blood cell (WBC), C-reactive protein (CRP), somatostatin (SST) and vasoactive intestinal peptide (VIP) were lower than those in the control group, motilin (MTL) was higher than that in the control group, the differences between the two groups were statistically significant (P < 0.05); The incidence of complications in the observation group was lower than that in the control group, but there was no significant difference between the two groups (P > 0.05).Conclusion 3D laparoscopy can significantly improve the clinical indicators, postoperative recovery indicators, inflammatory status and plasma gastrin-related indicators in elderly patients with distal gastric cancer, and help reduce the incidence of complications in patients. It is worthy of clinical application.