关键词: 膜解剖, 胃癌, 腹腔镜下根治术, 并发症, 高迁移率族蛋白B1, 疼痛, 复发〖

Abstract: Objective To investigate the effect of membrane dissection in radical gastrectomy for gastric cancer.Methods From August 2018 to October 2020,146 cases of patients with gastric cancer who were diagnosed and treated in our hospital were selected as the research objects.All the patients were divided into membrane anatomy group and control group with 73 cases each groups accorded to the 1∶1 random envelope drawing principle.The membrane anatomy group were underwent laparoscopic radical gastric cancer surgery under the guidance of membrane anatomy theory,and the control group were received traditional vascular guided laparoscopic radical gastric cancer surgery,and were to record and follow-up the prognosis of patients. Results The operation time,intraoperative blood loss,number of lymph nodes dissected,postoperative exhaust time,postoperative time to get out of bed and postoperative hospital stay in the membrane anatomy group were less than those of the control group(P<0.05).The incidence of complications such as incision infection,lung infection,abdominal hemorrhage,and anastomotic leakage in the membrane anatomy group were 2.7%,which were lower than 21.9% in the control group at 7 d after operation(P<0.05).The pain visual analogue scale(VAS) scores of the membrane anatomy group at 1 d,3 d,and 7 d were lower than those of the control group(P<0.05).The levels of serum high mobility group protein B1(hMGB1) in the membrane anatomy group at 1d,3d and 7d after operation were lower than those of the control group(P<0.05).All patients were followed up until October 1,2021.The recurrence rate and mortality rate of the membrane anatomy group were 16.4% and 8.2%,which were lower than those of the control group,31.5% and 20.5%(P<0.05). Conclusion The application of membrane anatomy in radical gastric cancer surgery can effectively reduce the occurrence of complications,reduce surgical trauma,and promote patient recovery.It can also effectively relieve pain and inhibit the release of hMGB-1,thereby reducing the follow-up recurrence rate and mortality of patients.

Key words: membrane anatomy, gastric cancer, laparoscopic radical resection, complications, high mobility group protein B1, pain, recurrence