摘要
Abstract
Objective To explore the safety,feasibility and short-term prognosis of laparoscopic radical gastrectomy for gastric cancer combined with 8p lymph node group dissection through the common hepatic artery posterior approach.Methods Retrospective analysis of the clinical data of 560 patients undergoing laparoscopic radical gastrectomy for gastric cancer from January 2018 to September 2021.According to the actual surgical methods,they were divided into two groups.The observation group(182 cases)received laparoscopic radical gastrectomy for gastric cancer combined with lymph node 8p dissection through the common hepatic artery posterior approach,while the control group received standard laparoscopic radical gastrectomy for gastric cancer.Compare the surgery-related indicators of the two groups,and analyze the correlation between lymph nodes in the 8p group and lymph node metastasis in the upper pancreatic region,and the prognostic effect of 8p group lymph node metastasis was analyzed.Results The observation group had longer surgical time and more total lymph node detection than those of the control group,with a statistically significant difference(P<0.05).The proportion of postoperative tumor N2 and N3 staging in the observation group was higher than that in the control group,with a statistically significant difference(P<0.05),but no significant difference was observed in the length of postoperative hospital stay between the two groups(P>0.05).There was no statistically significant difference in complications such as intraoperative portal vein injury,common hepatic artery injury,postoperative traumatic pancreatitis,pancreatic leakage,lymphatic leakage,and abdominal bleeding.23 cases(12.64%)in the observation group had lymph node metastasis in the 8p group.Univariate analysis and multivariate Logistic regression analysis showed that lymph node metastasis in the 8p group was associated with lymph node metastasis in the 7,8a,and 11p groups of the upper pancreatic region.After 3～66 months of follow-up(median follow-up time was 49 months),the 1 and 3 year survival rates of the 8p node-positive group were 78.20%and 39.10%,respectively,the negative group was 89.90%and 76.10%,the difference was statistically significant(P<0.05).Conclusion Gastric cancer patients have a certain rate of lymph node 8p group metastasis.Lymph node metastasis in the 7,8a and 11p group of the suprapancreatic region is a risk factor for 8p group lymph node metastasis,8p group lymph node dissection has a higher degree distribution of lymph node metastasis in patients with gastric cancer,and lymph node 8p metastasis is an important prognostic factor for gastric cancer patients.Laparoscopic radical gastrectomy for gastric cancer combined with 8p group lymph node dissection through the common hepatic artery posterior approach can improve the effectiveness of lymph node dissection without increasing surgical side injuries and postoperative complications.It is safe and feasible.关键词
腹腔镜胃癌根治术/肝总动脉后入路/8p组淋巴结Key words
laparoscopic radical gastrectomy for gastric cancer/posterior approach of common hepatic artery/8p group lymph node分类
医药卫生
