腹腔镜与开腹远端胃癌根治术的同期临床对比研究

A clinical camparative study of laparoscopic and distal gastrectomy in gastric cancer treatment during the same period

目的:比较腹腔镜与传统开腹远端胃癌根治术在胃癌治疗中的应用。方法:将需行远端胃癌根治术的患者64例根据意愿分为接受腹腔镜组30例和传统开腹组34例,对比2组手术的安全性、术后恢复、肿瘤根治性及医疗费用。结果:2组均无术中术后并发症和手术死亡病例,腹腔镜组3例中转开腹手术;腹腔镜组手术时间、术中出血、术后并发症与开腹组差异无统计学意义(P>0.05);腹腔镜组患者排气时间、下床时间、住院时间分别为(2.24±0.56)(、3.94±1.64)(、13.94±6.5)天,显著短于开腹组(P<0.05);腹腔镜组手术切除标本长度为(12.25±2.32)cm,清扫第一站淋巴结、第二站淋巴结以及淋巴结总数分别为(6.82±4.72)(、9.22±5.81)和(26.02±7.65)枚,与开腹组差异无统计学意义(P>0.05);手术费及药费合计与开腹组差异亦无统计学意义(P>0.05)。结论:腹腔镜远端胃癌根治术安全、有效、经济,符合肿瘤根治原则。

Objective：To compare the effects of laparoscopic and distal gastrectomy in gastric cancer treatment.Methods：Sixty-four patients with gastric cancer were divided into laparoscopic group and traditional gastrectomy group.The differences of safety,postoperative recovery,radical effect of tumor and cost of medicine between the two groups were compared.Results：There were no postoperative complications and operative deaths in 30 patients of laparoscopic group and 34 patients of traditional gastrectomy group.There were 3 patients of laparoscopic group converted to traditional gastrectomy during laparoscopic surgery.The operative time,blood loss,postoperative complications had no significant differences between the two groups（P0.05）;The time of patients′ exhaust and down bed,and the days of hospital stay in patients accepted laparoscopic surgery were significantly shorter than that in patients accepted gastrectomy（P0.05）;the length of resected tissues and the total number of lymph nodes excised were no significant differences between the two groups,neither the total medical costs（P0.05）.Conclusions：The laparoscopic distal gastrectomy were safe,effective,economic,and consistent with the principles of cancer therapy.