腹腔镜、胃镜联合治疗早期胃癌的临床体会

Application experience of laparoscopy combined with endoscopy for treating early gastric cancer

目的:探讨腹腔镜与胃镜联合行早期胃癌手术的可行性和临床价值。方法:将2007年4月至2010年6月56例早期远端胃癌患者随机分为两组,其中实验组26例,施行腹腔镜联合胃镜胃癌根治术;对照组30例,施行常规开腹胃癌根治术,对比分析两组手术时间、术中副损伤、术中出血量、术后肠功能恢复、术后并发症及住院时间。结果:实验组与对照组手术时间平均(128±26)min、(96±20)min,两组差异有统计学意义(P<0.05)。术中出血量分别为(86±22)ml、(128±20)ml,术后肠功能恢复时间平均(28±10)h、(70±22)h,术后平均住院(5.9±2.4)d和(9.3±2.8)d,实验组明显优于对照组(P<0.05)。两组术中均无副损伤发生。结论:腹腔镜与胃镜联合行早期胃癌根治术安全、可行、有效,微创效果明显,手术近期疗效满意。

Objective：To investigate the feasibility and clinical value of laparoscopy combined with endoscopy for treating early gastric cancer.Methods：From Apr.2007 to Jun.2010,56 patients with of early distal gastric cancer were randomly divided into experimental group and control group,the experimental group performed laparoscopy combined with endoscopy gastric resection（D1） on 26 patients,the control group peformed conventional open radical gastrectomy（D1） on 30 patients.The operative time,intraoperative vice injury,blood loss,postoperative recovery of intestinal function,postoperative complications and hospital stay were compared between the two groups.Results：The mean operative time in the two groups was（128 ± 26）,（96 ± 20） min respectively,and the difference of operative time existed statistically significance（P0.05）.Blood loss was（86 ± 22） ml,（128 ± 20） ml respectively,the experimental group was significantly less than the control group（P0.05）.Postoperative intestinal function recovery time and postoperative hospital stay were（28 ± 10） hour,（70 ± 22） hour,（5.9 ± 2.4） day,（9.3 ± 2.8） day respectively,the experimental group was obviously superior to the control group（P0.05）.Two groups of patients were no vice injury and postoperative complications occurred.Conclusions：The laparoscopy combined with endoscopy for treating the early gastric cancer is safe and effective,minimally invasive effect is obvious,surgery short-term effect is satisfactory.