Title腹腔镜辅助胃癌根治术应用于肥胖患者手术安全性的评价
Other TitlesEfficacy evaluation of laparoscopy-assisted radical gastrectomy in obese patients with gastric ;cancer
Authors杨宏
邢加迪
崔明
张成海
姚震旦
张楠
苏向前
Affiliation100142,北京大学肿瘤医院暨北京市肿瘤防治研究所胃肠肿瘤微创外科 恶性肿瘤发病机制及转化研究教育部重点实验室
Keywords胃肿瘤 腹腔镜 胃切除术 肥胖 Stomach neoplasms Laparoscopy Gastrectomy Obesity
Issue Date2014
Publisher中华胃肠外科杂志
Citation中华胃肠外科杂志.2014,(8),776-780.
Abstract目的:探讨肥胖对腹腔镜辅助胃癌根治术手术安全性的影响。方法回顾性分析北京肿瘤医院胃肠肿瘤微创外科在2009年5月至2012年12月间行腹腔镜辅助胃癌根治术的214例患者的临床资料,其中体质量指数大于或等于25 kg/m2者66例(肥胖组),低于25 kg/m2者148例(非肥胖组),比较两组患者的手术及术后恢复情况。结果肥胖组手术时间(271.5±51.2) min,明显长于非肥胖组的(252.1±53.6) min(P<0.05);清扫淋巴结数目(26.2±10.3)枚,少于非肥胖组的(30.3±12.4)枚(P<0.05)。但两组术中失血量、术中输血率、中转开腹率、术后排气时间和住院时间等差异均无统计学意义(均P>0.05)。肥胖组术后并发症发生率为25.8%(17/66)和20.9%(31/148),差异无统计学意义(P>0.05),但肥胖组手术相关轻微并发症(Clavien-Dindo分级Ⅰ、Ⅱ级)发生率(16.7%,11/66)高于非肥胖组(6.8%,10/148),差异有统计学意义(P<0.05)。两组术后30 d内死亡率分别为1.5%(1/66)和0.7%(1/148),差异无统计学意义(P>0.05)。结论肥胖患者会延长腹腔镜辅助胃癌根治术的手术时间,增加轻微并发症的风险,但并不影响手术的安全性。
To investigate the influence of obesity on short-term outcomes after laparoscopy-assisted radical gastrectomy.Clinical data of 214 patients with gastric cancer, who underwent laparoscopy-assisted radical gastrectomy between May 2009 and December 2012 were analyzed retrospectively. Patients were divided into two groups, consisting of obese and non-obese patients. In the obese group, the BMI was ≥ 25.0 kg/m2 (n=66), and in the non-obese group was <25.0 kg/m2 (n=148). Operative procedure and postoperative recovery were compared between the two groups.The operative time was longer in obese group than that in non-obese group [(271.5 ± 51.2) min vs. (252.1 ± 53.6) min, P<0.05]. The number of retrieved lymph nodes in obese group was less than that in non-obese group (26.2 ± 10.3 vs. 30.3 ± 12.4, P<0.05). No significant differences were observed in terms of blood loss, blood transfusion rate, conversion to laparotomy and time to first flatus between these two groups (all P>0.05). There were no significant differences between the two groups with respect to postoperative complications rate (25.8% vs. 20.9%, P>0.05) and perioperative mortality (1.5% vs. 0.7%, P>0.05). However, minor surgery-related complication rate was higher in obese group(16.7% vs. 6.8%, P<0.05), mainly presented as delayed gastric emptying. There was no difference in perioperative mortality between the two groups (1.5% vs. 0.7%, P>0.05).Although obesity prolongs the duration of laparoscopy-assisted radical gastrectomy, and increases the risk of minor surgery-related complications, it has no influence on the surgical safety.
URIhttp://hdl.handle.net/20.500.11897/189210
ISSN1671-0274
DOI10.3760/cma.j.issn.1671-0274.2014.08.010
IndexedPubMed
中国科技核心期刊(ISTIC)
中国科学引文数据库(CSCD)
Appears in Collections:北京肿瘤医院

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