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腹腔镜下胃癌开放手术:评估时间、恢复情况、并发症及标志物。

Laparoscopic open surgery for gastric cancer: Assessing time, recovery, complications, and markers.

作者信息

Lu Yun-Yao, Li Yun-Xiao, He Meng, Wang Ya-Li

机构信息

Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing University Cancer Hospital, Chongqing 400030, China.

出版信息

World J Gastrointest Surg. 2024 Jan 27;16(1):40-48. doi: 10.4240/wjgs.v16.i1.40.

Abstract

BACKGROUND

Gastric cancer (GC) is one of the most common cancers worldwide. Morbidity and mortality have increased in recent years, making it an urgent issue to address. Laparoscopic radical surgery (LRS) is a crucial method for treating patients with GC; However, its influence on tumor markers is still under investigation.

AIM

To determine the effects of LRS on patients with GC and their serum tumor markers.

METHODS

The data of 194 patients treated at Chongqing University Cancer Hospital between January 2018 and January 2019 were retrospectively analyzed. Patients who underwent traditional open surgery and LRS were assigned to the control ( = 90) and observation groups ( = 104), respectively. Independent sample -tests and tests were used to compare the two groups based on clinical efficacy, changes in tumor marker levels after treatment, clinical data, and the incidence of postoperative complications. To investigate the association between tumor marker levels and clinical efficacy in patients with GC, three-year recurrence rates in the two groups were compared.

RESULTS

Patients in the observation group had a shorter duration of operation, less intraoperative blood loss, an earlier postoperative eating time, and a shorter hospital stay than those in the control group ( < 0.05). No significant difference was observed between the two groups regarding the number of lymph node dissections ( > 0.05). After treatment, the overall response rate in the control group was significantly lower than that in the observation group ( = 0.001). Furthermore, after treatment, the levels of carbohydrate antigen 19-9, cancer antigen 72-4, carcinoembryonic antigen, and cancer antigen 125 decreased significantly. The observation group also exhibited a significantly lower incidence rate of postoperative complications compared to the control group ( < 0.001). Additionally, the two groups did not significantly differ in terms of three-year survival and recurrence rates ( > 0.05).

CONCLUSION

LRS effectively treats early gastric cancer by reducing intraoperative bleeding, length of hospital stays, and postoperative complications. It also significantly lowers tumor marker levels, thus improving the short-term prognosis of the disease.

摘要

背景

胃癌(GC)是全球最常见的癌症之一。近年来其发病率和死亡率不断上升,这使其成为一个亟待解决的问题。腹腔镜根治性手术(LRS)是治疗GC患者的关键方法;然而,其对肿瘤标志物的影响仍在研究中。

目的

确定LRS对GC患者及其血清肿瘤标志物的影响。

方法

回顾性分析2018年1月至2019年1月在重庆大学附属肿瘤医院接受治疗的194例患者的数据。接受传统开放手术和LRS的患者分别被分配到对照组(n = 90)和观察组(n = 104)。采用独立样本t检验和χ²检验,根据临床疗效、治疗后肿瘤标志物水平变化、临床数据和术后并发症发生率对两组进行比较。为了研究GC患者肿瘤标志物水平与临床疗效之间的关联,比较了两组的三年复发率。

结果

观察组患者的手术时间较短,术中出血量较少,术后进食时间较早,住院时间比对照组短(P < 0.05)。两组之间的淋巴结清扫数量无显著差异(P > 0.05)。治疗后,对照组的总缓解率显著低于观察组(P = 0.001)。此外,治疗后,糖类抗原19-9、癌抗原72-4、癌胚抗原和癌抗原125水平显著下降。与对照组相比,观察组术后并发症的发生率也显著较低(P < 0.001)。此外,两组在三年生存率和复发率方面无显著差异(P > 0.05)。

结论

LRS通过减少术中出血、住院时间和术后并发症有效治疗早期胃癌。它还显著降低肿瘤标志物水平,从而改善疾病的短期预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9e7a/10845286/2a60fcde18cb/WJGS-16-40-g001.jpg

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