目的 探讨进展期胃癌D2根治术中No.8p淋巴结转移与临床病理参数的相关性.方法 回顾性分析安徽医科大学附属六安医院2018年1月至2020年12月70例进展期胃癌患者的临床资料,采用多因素logistic回归分析肿瘤大小、发生部位、组织类型、组织学分级、Borrmann分型、浸润深度、肿瘤N分期、No.8a组淋巴结转移情况与No.8p组淋巴结转移的关系.结果 No.8p组淋巴结转移率为11.43％.单因素分析显示,病灶位于胃大弯侧和小弯侧、低分化和高中分化、浸润型和局限型、No.8a组淋巴结转移与否之间,No.8p组淋巴结转移情况差异存在统计学意义(P<0.05).logistic多因素分析显示,肿瘤位于小弯侧、低分化、No.8a组淋巴结转移,No.8p组淋巴结转移的危险因素(P<0.05).结论 进展期胃癌No.8p组淋巴结转移率较高,肿瘤位于小弯侧、低分化、No.8a组淋巴结转移时需重视No.8p组淋巴结转移.

Objective To investigate the safety and efficiency of practicing enhanced recovery after surgery (ERAS) concept in primary liver cancer, patients undergoing hepatectomy.Methods 90 patients with primary liver cancer were enrolled in the study.According to different methods of perioperative management, all cases were assigned into ERAS group (n =45) and control group (n =45).Outcome measures were time to functional recovery, postoperative length of stay (LOS), hospital costs, postoperative complications, numerical rating scale (NRS) scores on postoperative 24, 48 h, time to independent mobility, time to first passage of stool, readmission rate and mortality.Results Compared with control group, the ERAS group had significantly shorter time to functional recovery (t =4.003, P =0.000) and postoperative LOS (t =3.090, P =0.003), less hospital charges (t =2.281, P =0.025), lower general postoperative complication (x2 =4.286, P =0.038), lower NRS scores on postoperative 24, 48 h (t =2.851, 3.890, P =0.005, 0.000), shorter time to independent mobility (x2 =21.485, P =0.000), shorter time to first passage of stool (t =2.390, P=0.019).There were no differences in readmission rate and mortality.Conclusions ERAS was safe and efficacious, with less LOS and hospital charges and accelerated recovery for patients undergoing hepatectomy for primary liver cancer.