腹腔镜辅助下近端胃癌D2根治术的近期疗效分析

Curative effect observation for advanced gastric cancer by laparoscopic-assisted surgery

目的探讨腹腔镜辅助下近端进展期胃癌D2根治术的近期疗效。方法回顾性分析我院2014年1月~2015年3月间行手术治疗的66例进展期近端胃癌患者的临床资料,根据手术方式的不同分为观察组和对照组,观察组（36例）采用腹腔镜辅助下胃癌根治术,对照组（30例）采用经腹近端胃癌根治术,对两组患者手术相关指标及术后并发症等进行比较。结果两组患者手术时间、术中出血量、进流食时间、下床活动时间、切口长度、清扫淋巴结数及住院天数进行比较,除清扫淋巴结数目外,差异均有统计学意义（P〈0.05）;两组患者吻合口漏、吻合口出血、腹腔感染、胸腔积液、淋巴漏、肺部感染、切开液化感染及胃瘫等并发症的发生率进行比较,观察组术后并发症的发生率为11.11%（4/36）,对照组为33.33%（10/30）,差异有统计学意义（P〈0.05）。结论腹腔镜辅助胃癌根治术微创优势明显,其肿瘤根治程度与开腹胃癌根治术相当,有望成为进展性胃癌的标准术式。

Objective To explore the curative effect for advanced gastric cancer of laparoscopic-assisted surgery. Methods All 66 patients with advanced gastric cancer were retrospectively analyzed from January 2014 to March 2015 as the research object.According to the different methods of operation, they were divided into observation group and control group, the observation group （36 cases） had cure by lapm：oscopic-assisted surgery, the control group （30 cases） were by radical open surgery. Related indicators of two groups were compared. Results Operation time, intraoperative blood loss, time of the liquid diets, ambulation time, incision length, cleaning the number of lymph nodes, and hospital- ization days of two groups were compared, in addition to cleaning the number of lymph nodes, the difference was statis- tically significant （P〈0.05）; the incidence of complications of anastomotic leakage, anastomotic bleeding, abdominal cav- ity infection, pleural effusion, and lymph leakage, pulmonary infection, infection of incision liquefaction, and gastric paralysis of two groups have a comparison, the incidence of postoperative complications of the observation group was 11.11% （4/36）, the control group was 33.33% （10/30）, the difference was statistically significant （P〈0.05）. Conclusion Advanced gastric cancer by laparoscopic-assisted surgery have obvious advantages,it is expected to become the stan- dard operation for advanced gastric cancer.