进展期胃癌腹腔镜与开腹手术3年疗效的对比研究

A comparative study on 3-year clinical outcomes of laparoscopic and open radical resection for advanced gastric cancer

目的对比研究进展期胃癌患者腹腔镜与开腹根治手术后3年疗效。方法回顾性分析2008年1月至2009年12月在我院接受胃癌根治术的患者,根据纳入与排除标准,筛选出58例开腹根治手术患者,54例腹腔镜根治手术患者,所有患者术后根据临床分期接受以5-氟尿嘧啶为基础的辅助化疗,比较两组患者的临床病理、肿瘤安全学指标以及3年总体生存率、3年无病生存率。结果两组患者性别、年龄、肿瘤部位、肿瘤浸润深度、临床TNM分期比较,差异无统计学意义。腹腔镜组与开腹手术组平均淋巴结清扫数目分别为(23.5 9.6)、(23.0 8.5)个,差异无统计学意义(P>0.05)。腹腔镜手术组与开腹手术组患者3年总体生存率分别为66.3%、67.5%,差异无统计学意义(P=0.628)。腹腔镜手术组与开腹手术组之间3年无病生存率分别为63.4%和64.8%,差异无统计学意义(P=0.318)。结论进展期胃癌行腹腔镜辅助胃癌根治术安全有效,3年内疗效与开腹手术的无明显差异。

Objective To compare retrospectively the postoperative 3-year clinical outcomes of laparoscopic and open radical resection for advanced gastric cancer. Methods From January 2008 and December 2009,58 patients undergoing open radical resection and 54 laparoscopic radical resection for advanced gastric cancer were enrolled into the study according to the inclusion and exclusion criteria. All the patients received postoperative adjuvant chemotherapy with 5-Fu based regimen. The clinicopathological data and 3-year survival were compared between the laparoscopic and open groups. Results There were no significant differences in age, gender, tumor location, depth of invasion and clinical TNM stages between the two groups(P>0.05). The mean number of lymph nodes harvested was(23.5 9.6) in the laparoscopic group,(23.0 8.5) in the open group(P>0.05). The 3-year overall survival rates were 66.3% and 67.5%(P=0.628), 3-year disease-free survival rates 63.4% and 64.8% respectively in the laparoscopic and open groups(P=0.318). Conclusions Laparoscopic radical gastrectomy for advanced gastric cancer is safe and effective. The 3-year survival and recurrence after laparoscopic radical resection are similar to open surgery.