腹腔镜辅助贲门癌手术淋巴结清扫效果评价

Effect Evaluation of Laparoscopy-Assisted Surgery for Lymph Node Dissection in Patients with Carcinoma of Gastric Cardia

目的评价腹腔镜辅助贲门癌手术淋巴结清扫的效果。方法回顾性分析2004年1月至2009年9月期间我院分别行腹腔镜辅助及开腹贲门癌手术患者的临床资料,比较术后获取的淋巴结数目。结果 39例患者接受腹腔镜辅助贲门癌手术(腹腔镜组),63例患者接受开腹手术(开腹组)。2组患者术前合并症、病理学类型及病理分期差异无统计学意义(P>0.05)。腹腔镜组获取淋巴结(16.44±6.25)枚,其中第一站淋巴结(10.56±3.78)枚,转移率为74.4%;第二站淋巴结(3.82±1.82)枚,转移率为46.2%;第三站淋巴结(2.00±1.36)枚,转移率为5.1%。开腹贲门癌手术获取淋巴结(16.38±5.83)枚,其中第一站淋巴结(10.94±3.91)枚,转移率为71.4%;第二站淋巴结(3.71±1.55)枚,转移率为42.9%;第三站淋巴结(1.75±1.06)枚,转移率为3.2%,2组淋巴结清扫数目及转移率比较差异均无统计学意义(P>0.05)。结论腹腔镜辅助贲门癌手术淋巴结清扫效果满意,其远期疗效尚在继续观察中。

Objective To evaluate the effect of laparoscopy-assisted surgery for lymph node dissection in patients with carcinoma of gastric cardia.Methods The clinical data of patients with carcinoma of gastric cardia who underwent either laparoscopy-assisted or open gastrectomy between January 2004 and September 2009 in the Department of General Surgery,the Nanchong Central Hospital were analyzed retrospectively.The number of lymph node dissection was compared.Results Thirty-nine patients underwent laparoscopy-assisted gastrectomy（laparoscopy group） and 63 patients underwent open gastrectomy（open group）.There was no significant difference in preoperative complications,type of pathology or pTNM stage between two groups（P0.05）.The number of lymph node dissection was 16.44±6.25 in the laparoscopy group,of which the number of first station lymph node was 10.56±3.78（metastasis rate was 74.4%）,the second station was 3.82±1.82（metastasis rate was 46.2%）,the third station was 2.00±1.36（metastasis rate was 5.1%）;in the open group,the numbers of corresponding lymph node were 16.38±5.83,10.94±3.91（metastasis rate was 71.4%）,3.71±1.55（metastasis rate was 42.9%）,and 1.75±1.06（metastasis rate was 3.2%）,respectively.There was no significant difference between two groups（P0.05）.Conclusion The effectiveness of lymph node dissection is satisfactory by laparoscopy-assisted surgery for patients with carcinoma of gastric cardia,but prospective efficacy is still being followed up.