本文選題：腹腔鏡 + 胃切除術(shù)�。� 參考：《蘭州大學(xué)》2015年碩士論文

【摘要】：目的：通過比較腹腔鏡輔助與開腹全胃切除術(shù)治療進展期胃癌的臨床療效,評估腹腔鏡輔助下全胃切除術(shù)治療進展期胃癌的可行性和手術(shù)安全性。方法：收集2013年7月至2015年1月在蘭州大學(xué)第二醫(yī)院普外科手術(shù)治療的進展期胃癌患者170例(腹腔鏡輔助下全胃切除術(shù)65例,開腹全胃切除術(shù)105例)。分析比較兩組患者的基本資料、病理特征、圍手術(shù)期臨床結(jié)果、術(shù)后并發(fā)癥。結(jié)果：與開腹全胃切除術(shù)相比,腹腔鏡輔助下全胃切除術(shù)治療進展期胃癌的淋巴結(jié)清掃數(shù)目無顯著性差異,腹腔鏡組術(shù)后住院時間短,術(shù)后通氣時間早,首次進食時間早,術(shù)中出血量少,術(shù)后并發(fā)癥少,術(shù)后疼痛輕等優(yōu)點；但是,腹腔鏡組手術(shù)時間較長。結(jié)論：腹腔鏡輔助下全胃切除術(shù)治療進展期胃癌的根治程度與開腹全胃切除術(shù)相似,且具有創(chuàng)傷小、恢復(fù)快、并發(fā)癥發(fā)生率較低等優(yōu)勢。目的：系統(tǒng)評價腹腔鏡輔助全胃切除術(shù)與開腹全胃切除術(shù)治療進展期胃癌的手術(shù)安全性和淋巴結(jié)清掃程度。方法：計算機檢索CENTRAL Medline (Pubmed)、Embase、中國生物醫(yī)學(xué)文獻數(shù)據(jù)庫、萬方數(shù)據(jù)庫及中國知網(wǎng)數(shù)據(jù)庫等,檢索日期自1994年1月至2014年3月。納入腹腔鏡輔助全胃切除術(shù)對比開腹全胃切除術(shù)治療進展期胃癌的所有隨機對照試驗和非隨機對照研究,對納入文獻進行質(zhì)量評價,并使用RevMan5.2軟件進行數(shù)據(jù)分析處理。結(jié)果：最終納入6篇文獻,共1,115例(腹腔鏡組547例,開腹組568例)患者。與開腹全胃切除術(shù)相比,腹腔鏡輔助全胃切除術(shù)治療進展期胃癌術(shù)后并發(fā)癥少,術(shù)中出血量少,術(shù)后住院時間短,但手術(shù)時間較長,兩種術(shù)式淋巴結(jié)清掃數(shù)目無明顯差異。結(jié)論：腹腔鏡輔助全胃切除術(shù)治療進展期胃癌與開腹全胃切除術(shù)相比有一定的微創(chuàng)優(yōu)勢,手術(shù)安全性好,且淋巴結(jié)清掃程度相似。
[Abstract]:Objective: to evaluate the feasibility and safety of laparoscopic assisted total gastrectomy in the treatment of advanced gastric cancer. Methods: from July 2013 to January 2015, 170 patients with advanced gastric cancer were treated by general surgery in the second Hospital of Lanzhou University, including 65 cases of total gastrectomy assisted by laparoscope and 105 cases of total gastrectomy. The basic data, pathological features, perioperative clinical results and postoperative complications were analyzed and compared between the two groups. Results: there was no significant difference in the number of lymph node dissection between laparoscopic assisted total gastrectomy and open gastrectomy. There were less intraoperative bleeding, less postoperative complications and less postoperative pain, but the operative time was longer in the laparoscopic group. Conclusion: laparoscopic assisted total gastrectomy is similar to open gastrectomy in the treatment of advanced gastric cancer, and has the advantages of less trauma, faster recovery and lower incidence of complications. Objective: to evaluate the safety and lymph node dissection of laparoscopic assisted total gastrectomy and open total gastrectomy in the treatment of advanced gastric cancer. Methods: CENTRAL Medline Pubmeda Embase, Chinese Biomedical Literature Database, Wanfang Database and China knowledge Network Database were searched by computer from January 1994 to March 2014. All randomized controlled trials and non-randomized controlled trials involving laparoscopic assisted total gastrectomy and open gastrectomy for advanced gastric cancer were included. The quality of the literature was evaluated and the data were analyzed with RevMan5.2 software. Results: a total of 1115 cases (547 cases of laparoscopic group and 568 cases of open group) were included in 6 articles. Compared with open gastrectomy, laparoscopic assisted total gastrectomy has less complications, less intraoperative bleeding, shorter postoperative hospital stay, but longer operation time. There is no significant difference in the number of lymph nodes dissection between the two operations. Conclusion: Laparoscopy-assisted total gastrectomy has some advantages over open total gastrectomy in the treatment of advanced gastric cancer. The operation is safe and the degree of lymph node dissection is similar.
【學(xué)位授予單位】：蘭州大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R735.2

【共引文獻】

相關(guān)期刊論文 前10條

1 甄四虎;侯會池;王少文;李偉;劉偉;;腹腔鏡輔助下進展期胃癌根治術(shù)56例分析[J];解放軍醫(yī)藥雜志;2012年03期

2 羅國德;曹永寬;張林;張國虎;王培紅;龔加慶;王永華;;腹腔鏡與開腹手術(shù)對進展期胃癌D2根治術(shù)的臨床對比分析[J];華西醫(yī)學(xué);2011年09期

3 饒蕓;駱群;程琳;李雪玲;孫梯業(yè);余佩武;;腹腔鏡和開腹胃癌根治術(shù)患者圍術(shù)期護理的比較[J];解放軍護理雜志;2008年20期

4 胥娟;阮曉茹;王婷婷;;腹腔鏡胃切除后食道-空腸/殘胃吻合術(shù)的手術(shù)配合[J];解放軍護理雜志;2010年19期

5 張志剛;石彥;余佩武;曾冬竹;錢峰;趙永亮;;腹腔鏡胃癌根治術(shù)后血漿胃動素、血管活性腸肽的變化[J];解放軍醫(yī)學(xué)雜志;2009年04期

6 于歌;唐波;余佩武;錢鋒;孫剛;牛嫣陽;;腹腔鏡與開腹胃癌手術(shù)腹腔沖洗液中IL-1β濃度的變化及其對腹膜間皮細胞與胃癌細胞黏附的影響[J];解放軍醫(yī)學(xué)雜志;2010年01期

7 胡小生;劉偉中;;腹腔鏡胃癌手術(shù)現(xiàn)狀與展望[J];江西醫(yī)藥;2011年08期

8 郝迎學(xué);錢鋒;王自強;趙永亮;唐波;余佩武;;Comparison of peritoneal free gastric cancer cells' detecting rates between laparoscopically assisted and open radical gastrectomy[J];Journal of Medical Colleges of PLA;2007年04期

9 孫明生;陳俊;邱榮飛;勒世聯(lián);熊隆信;;腹腔鏡胃癌根治術(shù)的臨床應(yīng)用[J];實用臨床醫(yī)學(xué);2007年06期

10 曹鈞;盧綺萍;馮毓靈;張智勇;;腹腔鏡輔助遠端胃癌根治術(shù)的臨床應(yīng)用[J];臨床外科雜志;2007年11期

相關(guān)博士學(xué)位論文 前10條

1 石彥;模擬CO_2氣腹環(huán)境對胃癌細胞增殖侵襲轉(zhuǎn)移能力的影響[D];第三軍醫(yī)大學(xué);2007年

2 郝迎學(xué);CO_2氣腹對胃癌細胞生物學(xué)特性及侵襲轉(zhuǎn)移能力影響的臨床與基礎(chǔ)研究[D];第三軍醫(yī)大學(xué);2009年

3 吳曉松;Lgr5在胃癌血管生成中的作用及其分子調(diào)控機制研究[D];中國人民解放軍軍醫(yī)進修學(xué)院;2013年

4 邵耘;MicroRNA-101與環(huán)氧化酶-2在胃癌組織中的表達及意義[D];南京醫(yī)科大學(xué);2013年

5 何斐;炎癥信號通路基因多態(tài)性、環(huán)境因素及肺炎衣原體感染與原發(fā)性肺癌易感性及預(yù)后研究[D];福建醫(yī)科大學(xué);2013年

6 褚光輝;基于iTRAQ技術(shù)的結(jié)直腸癌蛋白標(biāo)志物鑒定[D];第二軍醫(yī)大學(xué);2013年

7 曹芳麗;HPV感染與食管鱗癌患者預(yù)后關(guān)系的臨床研究[D];山東大學(xué);2014年

8 劉錦新;瞬時受體電位通道TRPM8在人乳腺癌細胞中的表達及其對細胞遷移能力的影響[D];南方醫(yī)科大學(xué);2014年

9 黃智清;腹腔鏡輔助下胃癌全胃切除及其聯(lián)合臟器切除的臨床研究[D];南方醫(yī)科大學(xué);2014年

10 楊小清;GLUT1與膀胱癌進展相關(guān)性及其分子機制的研究[D];天津醫(yī)科大學(xué);2014年

，

本文編號：1960697