腹腔镜辅助下胃癌根治术与传统开腹术对比研究

A Comparative Study of Laparoscopic Assisted Radical Gastrectomy and Traditional Open Surgery for Gastric Cancer

目的对比腹腔镜辅助下胃癌根治术与传统开腹术临床疗效与患者应激反应程度。方法回顾性选取我院收治的94例胃癌患者,将其中采用开腹胃癌根治术(ORG)治疗的46例纳入ORG组,采用腹腔镜辅助下胃癌根治术(LAGR)治疗的48例纳入LARG组。对比两组手术情况、术后恢复进程、术后各项指标及术后并发症发生率;术后3个月对比两组血清肿瘤标志物变化情况;随访1年,统计两组生存率、复发率与转移率。结果LARG组均顺利完成手术,未发生中转开腹;术后LARG组患者炎症指标水平低于ORG组(P均<0.05);LARG组手术用时长于ORG组,LARG组术中出血量与切口总长度均小于ORG组(P均<0.05);LARG组患者术后肠功能恢复时间、总住院时间均短于ORG组(P均<0.05);LARG组患者术后疼痛评分和术后并发症总发生率低于ORG组(P均<0.05);术后1年,两组复发率、转移率与生存率均未见统计学差异(P均>0.05)。结论腹腔镜辅助下胃癌根治术与传统开腹术相比,能够达到持平的手术效果,虽手术时间较长但术中出血量减少,术后应激反应程度减轻,术后恢复时间缩短。

Objective To compare the clinical efficacy and stress response level of gastric cancer patients after laparoscopic assisted radical gastrectomy and traditional open surgery.Methods A retrospective selection was conducted on 94 gastric cancer patients who underwent surgical treatment in our hospital.Among them,46 patients who underwent open radical gastrectomy(ORG)were included in the ORG group,and 48 patients who underwent laparoscopic assisted radical gastrectomy(LAGR)were included in the LARG group.Compared the surgical situation,postoperative recovery progress,various postoperative indicators and the incidence of postoperative complications in the two groups of patients.Subsequently,compared the changes of serum tumor markers between the two groups at 3 months after surgery.Follow up for 1 year and calculated the survival rate,recurrence rate,and metastasis rate for both groups.Results The surgeries of the LARG group were successfully completed without any conversion to open surgery.The levels of inflammatory markers in the LARG group were lower than those in the ORG group after surgery(all P<0.05).The surgery time in the LARG group was longer than that in the ORG group,and the intraoperative blood loss and total incision length in the LARG group were smaller than those in the ORG group(all P<0.05).The postoperative recovery time of intestinal function and total hospital stay in the LARG group were shorter than those in the ORG group(all P<0.05).The postoperative pain score and total incidence of postoperative complicationsof patients in the LARG group were lower than those in the ORG group(all P<0.05).One year after surgery,there was no statistically significant difference in the recurrence rate,metastasis rate and survival rate between the two groups(all P>0.05).Conclusion LAGR for gastric cancer can achieve a similar surgical effect compared to traditional open surgery.Although LAGRis conducted with longer time,it can reduce intraoperative bleeding,alleviate postoperative stress response,and shorten postoperative recovery time.