腹腔镜辅助下远端胃癌根治术与传统开腹远端胃癌根治术治疗进展期胃癌的对比分析

A comparative study between iaparoscopic-assisted and open distal radical operation for advanced gastric cancer

目的比较腹腔镜辅助下远端胃癌根治术与传统开腹远端胃癌根治术治疗进展期胃癌的疗效，探讨腹腔镜辅助下远端胃癌根治术治疗进展期胃癌的可行性和近期疗效。方法回顾性分析198例行腹腔镜辅助下远端胃癌根治术（腹腔镜组，91例）和传统开腹远端胃癌根治术（开腹组，107例）治疗的进展期胃癌患者的临床资料。结果腹腔镜组与开腹组相比手术时间长、术中出血量少、切口长度短、术后肛门排气时间早、术后住院时间短、恢复进食时间快[（260．08±26．28）min比（231．74±17．33）min、（152．13±51．05）ml比（348．00±110．36）ml、（5．02±0．82）cm比（19．13±1．57）cm、（2．79±0．75）d比（4．49±1．09）d、（9．97±2．08）d比（12．15±2．46）d、（6．91±1．44）d比（7．45±1．08）d，P〈0．05]，而两组清扫淋巴结数目、术后并发症比较差异无统计学意义（P〉0．05）。结论腹腔镜辅助下远端胃癌根治术是治疗进展期胃癌安全、可行且近期疗效良好的手术方法。

Objective To compare the effect of laparoscopic-assisted and open distal gastric cancer radical operation for advanced gastric cancer and evaluate the feasibility and short-term outcomes oflaparoscopic-assisted distal gastric cancer radical operation. Methods The clinical data of 198 patients from January 2007 to December 2011 were analyzed retrospectively. Ninety-one patients who underwent laparoscopic-assisted distal gastric cancer radical operation was in laparoscopy group, and 107 patients who underwent open distal gastric cancer radical operation was in open operation group. Results The operative time in laparoscopy group was significantly longer than that in open operation group [ （260.08 ±26.28） min vs. （231.74 ±17.33 ） min ], and intraoperative blood loss volume, incision length, recovery of bowel activity, time of stay in hospital and recovery eating were significantly shorter than those in open operation group [（ 152.13 ±51.05） ml vs.（348.00 ± 110.36） ml, （5,02± 0.82） cm vs.（19.13 ± 1.57） cm, （2.79 ±0.75） d vs.（4.49 ± 1.09） d, （9.97 ± 2.08） d vs.（ 12.15 ± 2.46）d, （6.91± 1.44） d vs.（7.45 ±1.08） d,P〈 0.05 ]. The total number of lymph nodes and postoperative complication had no significant difference between two groups （P 〉 0.05）. Conclusions The laparoscopic-assisted distal gastric cancer radical operation for advanced gastric cancer is safe and feasible. It has better short-term outcomes.