腹腔镜辅助近端胃癌根治术临床近期疗效

Comparative study of laparoscopic and open radical proximal gastrectomy for gastric cancer and factors associateed with complication

目的探讨腹腔镜辅助近端胃癌根治术近期临床疗效。方法回顾性分析2011年6月至2013年1月收治的48例腹腔镜近端胃癌根治术患者(腹腔镜组),同时选取临床资料与腹腔镜组相近的,行开腹近端胃癌根治术患者40例(开腹组)。比较两组在手术时间、出血量、清扫淋巴结数目、术后胃肠功能恢复时间和住院时间的情况。结果腹腔镜组手术时间、出血量、清扫淋巴结数目、术后胃肠功能恢复时间、住院时间分别为(164±38)min、(80±33)ml、(27.5±3.1)个、(2.5±0.8)d和(10.0±2.2)d。出血量、术后胃肠恢复时间、住院时间与开腹组比较,差异有统计学意义(P<0.05)。按胃周淋巴结组别观察两组淋巴结数目,腹腔镜组的NO.4、10、11d淋巴结平均清扫数目与开腹组比较,差异有统计学意义(P<0.05)。结论腹腔镜近端胃癌根治术能够达到与开腹手术相同的根治效果,且具有创伤小、恢复快、安全等优点。

Objective To evaluate the efficacy of laparoscopic and open radical proximal gastrectomy for gastric cancer and factors associateed with complication. Methods From June 2011 to January 2013, the hospital records of 48 gastric cancer patients were reviewed ( laparoscopy assisted gastrectomy, LAG group ). And 40 gastric cancer patients received open gastrectomy ( open group, OGgroup ). Operative time, blood loss, umber of lymph nodes dissected, time for passage of flatus and hosptial stay were analyzed in two groups. Results Operative time, blood loss, umber of lymph nodes dissected, time for passage of flatus and hosptial stay in LAG group was ( 164 ± 38 )min,( 80 ± 33 )ml, ( 27.5 ± 3.1 ),( 2.5 ± 0.8 )d and ( 10.0 ± 2.2 )d respectively. Blood loss, time for passage of flatus and hosptial stay were significantly lesser or shorter than in OG group ( P < 0.05 ). While the number of the retrieved NO.4sa.10.11d lymph node in LAG group were significantly more than those in OG group ( P < 0.05 ). Conclusions Laparoscopy radical proximal gastrectomy is a safe ,feasible procedure,which achieves the same efficacy and leads to quick postoperative recovery.