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目的:观察胃癌患者应用腹腔镜下全胃根治性切除术中保留脾脏的脾门淋巴结清扫的临床效果,并探讨保留脾脏的临床意义。方法:选取2010年5月至2013年11月在我院行全胃切除术患者55例,其中腹腔镜下行保留脾脏+脾门淋巴结清扫的全胃切除术患者30例作为观察组,行传统开腹脾切除+脾门淋巴结清扫的全胃切除术患者25例作为对照组,观察两组手术时间、术中出血量、脾门淋巴结清除程度。结果:1观察组患者术中出血量明显低于对照组(P<0.01);术后进食时间、术后下床活动时间及平均住院天数明显少于对照组(P<0.05);平均手术时间两组差异无统计学意义(P>0.05)。2两组患者淋巴结清扫平均数以及淋巴结阳性率差异无统计学意义(P>0.05)。结论:腹腔镜下全胃根治性切除术中保留脾脏的脾门淋巴结清扫效果显著,临床医师必须提高自身的技术水平,才能有效减少对脾脏的损伤。
Objective: To observe the clinical effect of laparoscopic splenectomy and lymph node dissection in patients with gastric cancer who underwent total laparoscopic radical gastrectomy and to explore the clinical significance of preserving the spleen. Methods: From May 2010 to November 2013, 55 patients undergoing total gastrectomy in our hospital were selected. Among them, 30 cases underwent total laparoscopic total gastrectomy with splenic and splenic lymph node dissection as the observation group. Twenty-five cases of total gastrectomy with abdominal splenectomy and splenic lymph node dissection were selected as the control group. The operation time, intraoperative blood loss and the degree of lymph node dissection in the spleen were observed. Results: 1 The bleeding volume of the observation group was significantly lower than that of the control group (P <0.01); the time of postoperative feeding, the time of going out of bed and the average length of hospital stay were significantly less than those of the control group (P <0.05); mean operative time There was no significant difference between the two groups (P> 0.05). There was no significant difference between the average number of lymph node dissection and lymph node positive rate in the two groups (P> 0.05). Conclusions: Laparoscopic radical gastrectomy for splenic splenic lymph node dissection has a significant effect. Clinicians must improve their technical level in order to effectively reduce the damage to the spleen.