【摘要】 目的探讨腹腔镜辅助胃癌D2根治术不常规放置腹腔引流管的可行性及其临床意义。方法回顾性分析2017年2月至2018年2月中国人民解放军总医院普通外科行择期腹腔镜辅助胃癌D2根治手术193例病人临床资料,其中43例未放置腹腔引流管,其余150例放置腹腔引流管,比较两组病人基线资料(包括年龄、性别、体重指数、手术方式、病理分期、分化程度)、术后住院日、术后排气时间、术后换药次数及并发症发生率。结果两组病人在平均年龄、性别构成、体重指数、手术方式、术后病理学分期及分化程度等方面差异均无统计学意义,无引流组较引流组术后住院日明显缩短[(7.17±0.14)d vs.(10.88±0.88)d,P<0.05],术后排气时间明显缩短[(3.39±0.21)d vs.(4.30±0.16)d,P<0.01],术后疼痛明显减轻[(VAS评分(3.23±0.61)vs.(5.39±0.42),P<0.05)],术后换药次数明显减少[(3.53±0.52)次vs.(7.81±1.05)次,P<0.05],二者在并发症发生率方面差异无统计学意义。结论腹腔镜辅助胃癌D2根治术后不放置腹腔引流管可加快病人康复,且并不增加并发症发生率,建议严格把控腹腔引流管放置指征,不建议常规预防性放置腹腔引流管。更多还原

【Abstract】 Objective To clarify the value of unconventional prophylactic drain placement in laparoscopy assisted D2 gastrectomy for gastric cancer.Methods The clinical data of 193 patients with gastric cancer who underwent laparoscopy-assisted D2 Gastrectomy in Department of General Surgery,Chinese PLA General Hospital between February 2017 and February 2018 were analyzed retrospectively.The patients were divided into two groups according to whether the abdominal drain was placed.The drain group comprised 150 patients with routine prophylactic intraabdominal drain placement and the no drain group comprised 43 patients without intra-abdominal drain placement after laparoscopy-assisted D2 gastrectomy.The general information,post-operative recovery and the incidence of postoperative complications were compared in the two groups.Results There was no significant difference in the general information and postoperative complications in the two groups.The no drain group had shorter hospital stay[(7.17±0.14)d vs.(10.88±0.88) d,(P<0.05)],and shorter exhaust time[(3.39±0.21)d vs.(4.30±0.16)d,P<0.01],less pain [VAS(3.23±0.61) vs.(5.39±0.42),(P<0.05)] and less times of wound dressing change after operation [(3.53±0.52)vs.(7.81±1.05),(P<0.05)] compared with the drain group.Conclusion The unconventional prophylactic drain placement in laparoscopy assisted D2 gastrectomy is safe and feasible.Unnecessary drain placement should be avoided.更多还原