新辅助化疗联合腹腔镜辅助胃癌根治术治疗进展期胃癌的临床疗效

Clinical effect of neoadjuvant chemotherapy combined with laparoscopic radical gastrectomy in treating advanced gastric cancer

目的探讨新辅助化疗联合腹腔镜辅助胃癌根治术治疗进展期胃癌的临床疗效。方法选取自贡市第四人民医院2015年1月—2016年3月收治的进展期胃癌患者69例,随机分为对照组30例和试验组39例。对照组患者采用传统开腹手术治疗,试验组患者采用新辅助化疗联合腹腔镜辅助胃癌根治术治疗。比较两组患者的手术指标(手术切除率、手术时间、术中出血量、术后胃肠道功能恢复时间)、不良反应发生情况,观察患者复发率、转移率。结果两组患者手术切除率比较,差异无统计学意义(P>0.05);试验组患者手术时间、术后胃肠道功能恢复时间短于对照组,术中出血量少于对照组(P<0.05)。试验组患者术后感染发生率低于对照组,胃肠道反应、肝功能异常、血液系统异常发生率高于对照组(P<0.05)。两组患者肿瘤复发率比较,差异无统计学意义(P>0.05);试验组患者肿瘤转移发生率低于对照组(P<0.05)。结论新辅助化疗联合腹腔镜手术治疗进展期胃癌的临床疗效确切,可有效缩短手术时间,且术后恢复快、转移率低。

Objective To investigate the clinical effect of neoadjuvant chemotherapy combined with laparoscopic radical gastrectomy in treating advanced gastric cancer. Methods A total of 69 cases of patients with advanced gastric cancer were selected from January 2015 to March 2016 in Zigong Fourth People’ s Hospital,which were randomly divided into control group（ n = 30） and experimental group（ n = 39）. Control group was treated with traditional open surgery for radical treatment,experimental group was given neoadjuvant chemotherapy combined with laparoscopic radical gastrectomy. The surgical indicators（ surgical resection rate,operation time,intraoperatve blood loss,gastrointestinal function recovery time） and the incidence of adverse reactions were compared between the two groups,and the tumor recurrence rate and metastasis rate were observed. Results No significantly difference of surgical resection rate was found between the two groups（ P 〉 0. 05）; the experimental group of operation time,gastrointestinal function recovery time were shorter than control group,intraoperatve blood loss was less than control group（ P 〈 0. 05）. The experimental group of postoperative infection rate was lower than control group,the rate of gastrointestinal reaction,abnormal liver function and blood system were higher than control group（ P 〈 0. 05）. No significantly difference of tumor recurrence rate was found between the two groups（ P 〉 0. 05）; the experimental group of tumor metastasis rate was lower than control group（ P 〈 0. 05）. Conclusion Neoadjuvant chemotherapy combined with laparoscopic radical gastrectomy have an exactly clinical effect in treating advanced gastric cancer,it can effectively shorten the operation time,and with quickly postoperative recovery,lower tumor metastasis rate.