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目的:比较腹腔镜胃癌根治术与传统开腹胃癌根治术对患者临床指标及术后肠道屏障功能的影响。方法:选择2016年1月—2016年6月符合条件的41例胃癌患者,其中21例行腹腔镜辅助胃癌D_2根治术(腔镜组),20例行开腹胃癌D_2根治术(开腹组)。比较两组患者相关临床指标及手术前后血浆二胺氧化酶(DAO)和内毒素(ETX)水平的变化。结果:两组患者的基本临床资料具有可比性。腔镜组手术切口长度、术中出血量均优于开腹组,但手术时间长于开腹组(均P<0.05),其他临床指标包括术中输血比例、清扫淋巴结数量、手术切缘、术后通气时间两组间差异无统计学意义(均P>0.05)。两组患者术后第1天DAO和ETX水平均较术前明显升高(均P<0.05),但随后均将至术前水平,两组术前与术后各时间点DAO和ETX水平差异均无统计学意义(均P>0.05),且DAO和ETX水平在两组患者中均呈正相关(r=0.759、r=0.559,均P<0.05)。两组感染性并发症发生率无统计学差异(P>0.05)。结论:腹腔镜辅助胃癌根治术与传统开腹胃癌根治术同样安全、有效,且对肠道屏障功能影响无明显增加。
Objective: To compare the effect of laparoscopic radical gastrectomy and conventional open radical gastrectomy on clinical parameters and postoperative intestinal barrier function. Methods: Forty-one patients with gastric cancer were eligible from January 2016 to June 2016, of whom 21 underwent laparoscopic assisted radical resection of gastric cancer (endoscopic group) and 20 underwent open radical resection of open gastric cancer (open group) ). The changes of plasma diamine oxidase (DAO) and endotoxin (ETX) levels in the two groups were compared before and after the operation. Results: The basic clinical data of two groups of patients were comparable. The length of operative incision and intraoperative blood loss in the endoscopic group were better than those in the open group, but the operation time was longer than that in the open group (all P <0.05). Other clinical indexes included intraoperative blood transfusion ratio, number of lymph nodes dissected, surgical margin, Post-ventilation time was no significant difference between the two groups (all P> 0.05). The DAO and ETX levels on the first day after operation in both groups were significantly higher than those before operation (all P <0.05), but the levels of DAO and ETX in both groups before and after operation were all lower than those before operation (All P> 0.05). There was a positive correlation between DAO and ETX levels in both groups (r = 0.759, r = 0.559, all P <0.05). There was no significant difference in the incidence of infectious complications between the two groups (P> 0.05). Conclusions: Laparoscopic assisted radical gastrectomy is as safe and effective as conventional open radical gastrectomy, and has no significant effect on intestinal barrier function.