腹腔镜D2根治术与开腹手术治疗胃癌的比较研究

Comparative study of laparoscopic gastrectomy D2 radical surgery and open gastrectomy for gastric cancer

目的通过比较同期开展的腹腔镜胃癌D2根治术与传统开腹胃癌D2根治术,以评价其安全性、肿瘤根治性以及术后早期疗效。方法选取2010年2月～2012年7月接受手术的316例胃癌患者为研究对象,其中166例采用传统开腹胃癌根治术(传统开腹组),150例患者接受腹腔镜胃癌根治术(腹腔镜手术组)。腹腔镜手术组与传统开腹组在性别、年龄、肿瘤位置、病理类型和TNM分期差异无统计学意义。结果两组在手术时间、出血量、切口长度、胃肠道恢复时间、术后首次进食流质时间和术后住院时间差异有统计学意义。两组的淋巴结清扫总数及并发症无统计学意义。结论腹腔镜胃癌D2根治术是一种安全、微创的手术方法。腹腔镜胃癌D2根治术与传统胃癌D2根治术可获得相同的淋巴结清扫范围及良好的早期疗效,但较开腹手术创伤小、术后恢复快等优势。

Objective Through comparison carried out at the same laparoscopic gastric D2 radical surgery with traditional open gastric D2 radical surgery to evaluate the safety, tumor radical and early postoperative efficacy. Methods Selected 316 patients with gastric cancer underwent surgery in February 2010 - 2012 in July for the study, 166 cases using conventional open gastrectomy （the traditional laparotomy group ） , 150 patients underwent laparoscopie radical gastrectomy （laparoscopic surgery group ）. Laparoscopic surgery group with traditional open surgery group no statistically significant differences in gender, age, tumor location, histological type and TNM staging. Results Two groups had statistically significant differences in operative time, blood loss, incision length, gastrointestinal recovery time, first time eating liquid and postoperative hospital stay. The total number of lymph node dissection and complications was not statistically significant. Conclusions Laparoscopic gastric D2 radical surgery is a safe, minimally invasive surgical method. Laparoscopic gastric D2 radical surgery has the same lymph node dissection and good early outcome compared with the traditional gastric D2 radical surgery, but postoperative recovery fast and less invasive.