腹腔镜与开腹对进展期胃癌根治术的临床疗效对比

Comparison on Clinical Effects of Laparoscopy with Laparotomy in Radical Surgery for Advanced Gastric Cancer

对比分析腹腔镜与开腹胃癌根治术的临床疗效。回顾性分析355例进展期胃癌患者临床资料,其中行腹腔镜D2根治术160例,行开腹D2根治术195例,对比分析两组患者的疗效指标。结果显示,与开腹组比较,腹腔镜组患者手术时间较长,但出血量更少,清扫淋巴结数量更多,术后肠道恢复功能更快,进食半流质时间早,住院时间更短,差异均有统计学意义(P<0.05)。两组患者近、远端切缘长度及术后并发症发生率的比较,差异无统计学意义(P>0.05)。结果表明,腹腔镜胃癌根治术是治疗进展期胃癌安全、可行、有效方法。

The clinical effects of laparoscopic radical surgery with conventional open radical surgery for advanced gastric cancer are compared.The clinical data of 355 patients who underwent gastrectomy are retrospectively analyzed.There were 160 patients undergoing laparoscopic gastrectomy with D2 lymph nodes dissection（LGD2） and 195 undergoing conventional open D2 gastrectomy（OGD2）.The following parameters are compared between these two groups： intraoperative factors,oncologic outcomes,and short-term outcomes.The operative time was significantly longer for the LGD2 group than that for the OGD2 group.The patients in the LGD2 group had less blood loss,more lymph node dissection,faster recovery of bowel activity,earlier semifluid diet time and shorter postoperative ambulation time.The differences are statistically significant.There are no significant differences in the length of distal and proximal margin and postoperative complications.The results show that LGD2 is a safe and feasible procedure for advanced gastric cancer.