新辅助化疗后行腹腔镜手术治疗进展期胃癌的临床疗效观察

Curative Effect of Laparoscopic Surgery after Neoadjuvant Chemotherapy in Advanced Gastric Cancer

目的观察新辅助化疗后行腹腔镜手术治疗进展期胃癌的临床疗效。方法选择我院2008年2月—2013年2月收治的进展期胃癌患者70例,采用随机数字表将患者分为对照组和观察组,每组35例。对照组不行新辅助化疗,直接行腹腔镜手术;观察组行新辅助化疗后再行腹腔镜手术。观察两组患者术后病理分期、手术并发症及术后复发情况。结果对照组术后病理分期Ⅱ期17例、ⅢA期14例、ⅢB期4例,观察组Ⅱ期15例、ⅢA期16例、ⅢB期4例,两组术后病理分期间差异无统计学意义(P=0.69)。对照组手术并发症发生率为11.4%(4/35),观察组为14.3%(5/35),两组并发症发生率间差异无统计学意义(P=0.72)。对照组总复发率为51.4%(18/35),观察组为25.7%(9/35),观察组总复发率低于对照组(P=0.03)。结论新辅助化疗后行腹腔镜手术治疗进展期胃癌有利于降低术后复发率,疗效较好,值得临床推广应用。

Objective To analyze the curative effect of laparoscopic surgery after neoadjuvant chemotherapy in advanced gastric cancer.Methods 70 patients with advanced gastric cancer admitted to our hospital from February 2008 to February 2013 were randomly divided into control group and observation group with each group 35 cases.The control group was given laparoscopic surgery without neoadjuvant chemotherapy,while the observation group was given laparoscopic surgery after neoadjuvant chemotherapy.The postoperative pathological stage,operative complication rate and postoperative recurrence rate were compared between the two groups.Results The postoperative pathological stages in the control group were: 17 cases of stage Ⅱ,14 cases of stage ⅢA and four cases of stage ⅢB;In the observation group were: 15 cases of stage Ⅱ,16 cases of stage ⅢA and four cases of stage ⅢB,respectively.The difference between the two groups was not statistically significant(P = 0.69).The operative complication rates in the control group and observation group were 11.4%(4 /35) and 14.3%(5 /35),respectively,showing no statistically significant difference(P = 0.72).The postoperative recurrence rates in the control group and observation group were 51.4%(18 /35) and 25.7%(9 /35),with the observation group significantly lower than the control group(P = 0.03).Conclusion Laparoscopic surgery after neoadjuvant chemotherapy in advanced gastric cancer can reduce recurrence rate and achieve good curative effect,and should be promoted in clinic.