[1]沈荐 李敏哲* 杜燕夫.腹型肥胖对局部进展期胃癌腹腔镜全胃D2根治术的影响[J].中国微创外科杂志,2021,01(11):977-981.
　Shen Jian,Li Minzhe,Du Yanfu..Effect of Abdominal Obesity on Laparoscopic Total Gastrectomy With D2 Lymph Node Dissection for Locally Advanced Gastric Cancer[J].Chinese Journal of Minimally Invasive Surgery,2021,01(11):977-981.
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腹型肥胖对局部进展期胃癌腹腔镜全胃D2根治术的影响()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2021年11期
页码:
977-981
栏目:
临床研究
出版日期:
2021-11-25

文章信息/Info

Title:
Effect of Abdominal Obesity on Laparoscopic Total Gastrectomy With D2 Lymph Node Dissection for Locally Advanced Gastric Cancer
作者:
沈荐 李敏哲* 杜燕夫
（首都医科大学附属北京朝阳医院普外科，北京100020）
Author(s):
Shen Jian;  Li Minzhe;  Du Yanfu.
Department of General Surgery, Beijing ChaoYang Hospital Affiliated to Capital Medical University, Beijing 100020, China
关键词:
腹型肥胖; 胃肿瘤; 进展期; 全胃切除术; 腹腔镜; 预后
Keywords:
Abdominal obesity; Stomach neoplasms; Advanced; Total gastrectomy; Laparoscopy; Prognosis
文献标志码:
A
摘要:
目的评估腹型肥胖对局部进展期胃癌腹腔镜全胃D2根治术的影响。方法回顾性分析2016年1月~2020年7月89例行腹腔镜全胃D2根治术的局部进展期胃癌患者的临床资料，以腰围男性≥85 cm、女性≥80 cm作为腹型肥胖标准，肥胖组32例，非肥胖组57例。比较2组围术期指标、术后病理指标和术后生存情况。结果2组均完成腹腔镜全胃D2根治术。对比非肥胖组，肥胖组手术时间更长［(247.5±33.2) min vs.(219.5±28.4) min，t=4.198，P=0.000］，术中失血更多［(157.8±57.0) ml vs.(125.4±42.4) ml，t=3.048，P=0.003］，术后肛门排气更晚［(3.2±0.8) d vs.(2.7±0.8) d，t=2.428，P=0.017］，术后住院时间更长［(15.1±4.4) d vs. (13.2±3.4) d，t=2.280，P=0.025］，2组中转开腹率、术中输血率、术后并发症发生率、淋巴结清扫数、淋巴结转移率、阳性淋巴结数、肿瘤pTNM分期差异均无显著性(P>0.05)。肥胖组术后随访6~60个月（中位数30.5月），2例（6.3%）复发，8例（25.0%）死亡；非肥胖组术后随访6~60个月（中位数27.0月），3例（5.3%）复发，12例（21.1%）死亡。2组术后复发率（χ2=0.000，P=1.000）及累积生存率差异均无显著性(logrank χ2=0.099，P=0.753)。结论腹型肥胖的局部进展期胃癌患者较之非肥胖患者，腹腔镜全胃D2根治手术的操作难度会增大，患者术后恢复更缓慢，但预后生存无显著差异。
Abstract:
ObjectiveTo evaluate the effect of abdominal obesity on laparoscopic total gastrectomy with D2 lymph node dissection for locally advanced gastric cancer.MethodsClinical data of 89 patients with locally advanced gastric cancer who underwent laparoscopic total gastrectomy with D2 lymph node dissection from January 2016 to July 2020 were retrospectively analyzed. The waist circumference of male ≥85 cm and female ≥80 cm was taken as the criteria of abdominal obesity. There were 32 cases in the obesity group and 57 cases in the nonobesity group. ResultsLaparoscopic total gastrectomy with D2 lymph node dissection was performed successfully in both groups. The operation time ［(247.5±33.2) min vs. (219.5±28.4) min, t=4.198, P=0.000］, the amount of intraoperative blood loss ［(157.8±57.0) ml vs. (125.4±42.4) ml, t=3.048, P=0.003］, the exhaust time ［(32±0.8) d vs. (2.7±0.8) d, t=2.428, P=0.017］, the postoperative hospital stay ［(15.1±4.4) d vs. (13.2±3.4) d, t=2.280, P=0025］ in the obese group were more than those in the nonobesity group. There were no significant difference in the conversion to laparotomy rate, intraoperative blood transfusion rate, postoperative complication rate, lymph node dissection number, lymph node metastasis rate, positive lymph node number, and tumor pTNM stage between the two groups (P>0.05). The patients in the obesity group were followed up for 6-60 months (median, 30.5 months). Two cases (6.3%) had recurrence, and 8 cases (25.0%) died. The patients in the nonobesity group were followed up for 6-60 months (median, 27.0 months). Three cases (53%) had recurrence, and 12 cases (21.1%) died. There was no significant difference in recurrence (χ2=0.000, P=1.000) and cumulative survival rate (logrank χ2=0.099, P=0.753) between the two groups.ConclusionsCompared with nonobesity patients, laparoscopic total gastrectomy with D2 lymph node dissection is more difficult in patients with abdominal obesity for locally advanced gastric cancer, with slower postoperative recovery. However, there was no significant difference in survival between the two groups.

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备注/Memo

备注/Memo:
*通讯作者，Email：liminzhe@ccmu.edu.cn
更新日期/Last Update: 2022-02-10