临床普外科电子杂志 ›› 2025, Vol. 13 ›› Issue (2): 28-.

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腹腔镜胃癌 D2 根治术对老年局部进展期胃癌患者的影响

  

  1. 1. 温州医科大学附属金华医院 肝胆胰胃肠外科,浙江 金华 321000;2. 南京医科大学附属无锡市人民医院 急诊外科,江苏 无锡 214000
  • 出版日期:2025-04-01 发布日期:2025-08-07
  • 基金资助:

    金华市公益性技术应用研究项目(2023-4-111)

The impact of laparoscopic D2 radical resection for gastric cancer on elderly patients with locally advanced gastric cancer

  1. 1. Hepatobiliary Pancreatic Gastrointestinal Surgery Department of Jinhua Hospital Affiliated to Wenzhou Medical University, Zhejiang Jinhua 321000, China; 2. Emergency Department of Wuxi People’s Hospital Affiliated to Nanjing Medical University, Jiangsu Wuxi 214000, China
  • Online:2025-04-01 Published:2025-08-07

摘要:

目的 探讨腹腔镜胃癌 D2 根治术治疗老年局部进展期胃癌患者的效果。方法 选取温州医科大学附属金华医院 2022 年 10 月至 2024 年 11 月收治的 86 例老年局部进展期胃癌患者,采用投掷硬币法分为参照组和研究组,各 43 例。参照组采用开腹胃癌 D2 根治术,研究组采用腹腔镜胃癌 D2 根治术。观察对比两组患者治疗前后的炎症因子以及应激反应指标水平、免疫功能相关指标水平以及术后并发症发生情况。结果 治疗前,两组患者的炎症因子以及应激反应指标水平、免疫功能相关指标水平比较无显著差异(P >0.05)。治疗后,研究组患者的炎症因子以及应激反应指标水平优于参照组,且 CD8+ T 细胞、CD4+ T 细胞百分比及其比值均高于参照组,差异均有显著性(P < 0.05)。研究组患者术后并发症总发生率为 2.33%,显著低于对照组(20.93%),差异有显著性(P=0.007)。结论 腹腔镜胃癌 D2 根治术治疗老年局部进展期胃癌患者,可有效改善患者炎症因子以及应激反应指标水平,提升患者的免疫功能,降低患者术后并发症发生风险。

关键词: 局部进展期胃癌, 腹腔镜胃癌 D2根治术, 炎症因子, 应激反应

Abstract:

Objective To explore the effect of laparoscopic D2 radical resection for elderly patients with locally advanced gastric cancer. Method 86 elderly patients with locally advanced gastric cancer admitted to Jinhua Hospital affiliated with Wenzhou Medical University from October 2022 to November 2024 were selected and divided into two groups using the coin toss method, with 43 patients in each group. The reference group underwent open D2 radical surgery for gastric cancer, while the study group underwent laparoscopic D2 radical surgery for gastric cancer. Observe and compare the levels of inflammatory factors, stress response indicators, immune function, and postoperative complications between two groups of patients before and after treatment. Result Before treatment, there was no significant difference in the levels of inflammatory factors, stress response indicators, and immune function between the two groups of patients (P > 0.05). After treatment, the levels of inflammatory factors and stress response indicators in the study group were better than those in the control group, and the percentages and ratios of CD8+T cells and CD4+T cells were higher than those in the control group, with significant differences (P < 0.05). The total incidence of postoperative complications in the study group was 2.33%, significantly lower than that in the control group (20.93%), with a significant difference (P=0.007). Conclusion Laparoscopic D2 radical resection for elderly patients with locally advanced gastric cancer can effectively improve the levels of inflammatory factors and stress response indicators, enhance the patient's immune function, and reduce the risk of postoperative complications.

Key words: Locally advanced gastric cancer, Laparoscopic D2 radical resection for gastric cancer, Infl ammatory factors, Stress response