腹腔镜辅助与开腹手术治疗进展期胃癌的对比研究

Comparison between Laparoscopic-assisted and Open Surgeries for Progressive Gastric Cancer

目的探讨腹腔镜手术治疗进展期胃癌的价值。方法回顾性分析2009年3月～2012年4月86例进展期胃癌的临床资料,其中40例腹腔镜辅助手术,46例开腹手术。比较两组手术时间、出血量、清扫淋巴结数、术后排气时间、术后并发症、住院时间及住院费用等。结果 2组手术时间、清扫淋巴结数、住院费用差异无显著性。与开腹组相比,腹腔镜组出血少[(226.6±49.5)ml vs.(305.3±29.3)ml,t=-9.107,P=0.000],术后排气早[(2.2±0.8)d vs.(3.4±0.9)d,t=-6.476,P=0.000],术后并发症少[0(0/40)vs.15%(7/46),P=0.013],住院时间短[(9.1±1.6)d vs.(12.5±1.6)d,t=-9.987,P=0.000]。结论腹腔镜辅助治疗进展期胃癌具有创伤小、出血少、恢复快等优点,近期优势较开腹手术明显。

Objective To discuss the value of laparoscopic-assisted gastrectomy in the treatment of progressive gastric cancer. Methods A retrospective analysis was made on 86 patients with progressive gastric cancer, who received laparoscopic- assisted （40 cases） or open gastrectomy （46 cases） during March 2009 to April 2012. The operation time, intraoperative blood loss, number of removed lymph nodes, postoperative recovery time of gastrointestinal function and complications, as well as hospital stay and hospitalization cost were compared between the two groups. Results No significant difference was detected in the operation time, number of removed lymph nodes, and hospitalization cost between the two groups. Compared to open surgery, the laparoscopic-assisted group showed significantly less intraoperative blood loss, quicker recovery or gastrointestinal time, lower rate of postoperative complications, and shorter hospital stay [ （226.6 ± 49.5 ） ml vs. （ 305.3 ± 29.3 ） ml, t = - 9. 107, P = 0. 000 ; （2.2 ±0. 8 ） d vs. （3.4 ±0.9） d, t= -6.476, P=0.000;O （0/40） vs. 15% （7/46）, P=0.013; and （9.1 ±1.6） d vs. （12.5±1.6） d, t= -9.987, P =0.000 ]. Conclusions Laparoscopic-assisted gastrectomy is safe and effective for progressive gastric cancer. The procedure is superior to open surgery in less invasion and intraoperative blood loss, and quicker recovery.