腹腔镜辅助与开腹胃癌根治术治疗进展期胃癌中的效果比较

Comparison of laparoscopic-assisted and open gastrectomy for advanced gastric cancer

目的 比较腹腔镜与传统胃癌根治术在进展期胃癌中的效果.方法 分析我院从2007年6月至2009年5月开展的30例进展期胃癌行腹腔镜下辅助胃癌根治术病例资料,与同期30例进展期胃癌行开腹胃癌根治术病例资料作为对照,比较两组患者的手术指标、术后恢复及肿瘤根治程度.结果腹腔镜组手术时间显著长于开腹组（P〈0.05）,但止痛剂使用次数、出血量和输血率、手术切口长度、术后第1天白细胞数目、术后第1天体温升高程度、肠功能恢复时间及总住院时间均小于开腹组（P〈0.05）,而在切缘距肿瘤距离、淋巴结清扫数目及近期并发症上两组差异无统计学意义（P均〉0.05）.结论 腹腔镜下胃癌D2根治术应用于治疗进展期胃癌,安全、可行、有效、创伤小且近期效果良好.

Objective To compare the effects between laparoscopic-assisted and open gastrectomy for advanced gastric cancer.Methods From June 2007 to May 2009,30 patients with advanced gastric cancer underwent laparoscopic-assisted gastrectomy and the other 35 advanced gastric cancer patients underwent open gastrectomy in our hospital were be compared.The parameters observed including： operation related indicators,postoperative recovery and extend of resection of tumors.Results The mean operation time of the laparoscope group was significantly longer than the Open Group,but the postoperative administration of anodyne,blood loss,the percent of blood transfusion,length of operative incision,number of white blood cell and neutrophilic granulocyte and the body temperature in the first day,the time of intestinal function recoverd and total hospital stay in the laparoscope group was less than the open group.The mean clear distal margin and proximal from tumor,average number of lymph nodes dissected and short-term complication in the laparoscope group was not significantly different from the open group.Conclusion The laparoscopy-assisted gastrectomy for advanced gastric cancer is safe,feasible,effective and minimally invasire technique,and its short-term outcome is favorable.