腹腔镜结合加速康复方案与传统胃癌手术近期疗效对比

Efficacy comparison of fast track surgery combined laparoscopic program with traditional gastric surgery

目的:评价在加速康复外科(FTS)指导下的腹腔镜胃癌根治术的安全性和有效性。方法:选取2009年7月至2011年1月符合条件的择期胃癌手术患者158例,将其分为FTS理念腹腔镜组(A组)及传统理念开腹组(B组),各79例。动态监测比较两组病人术前和术后第1、3、5天白细胞计数、C-反应蛋白(CRP)水平,对比两组手术时间、术中出血量、淋巴结清扫数目、术后下床时间、排气时间、术后住院时间、并发症发生率等指标。结果:术后免疫指标A组优于B组(P<0.05)。A组术中出血量、下床时间、排气时间、住院时间、术后并发症发生率均优于对照组(P<0.05)。B组手术时间长于A组(P<0.05),但两组淋巴结清扫数目比较,差异无统计学意义(P>0.05)。结论:结合加速康复外科理念的腹腔镜胃癌根治术在患者术后恢复、免疫影响等方面优势明显,且具有等同传统手术的安全性。

Objective：To evaluate the safety and effectiveness of laparoscopic radical gastrectomy under the guidance of fast track surgery.Methods：Total of 158 cases performed selective operation on radical gastrectomy for gastric cancer were chosen and divided into two groups（79 cases in each group）,FTS laparoscope group（Group A） and the traditional open surgery group（Group B）.Index of WBC on the first,third and fifth day before and after the operation,CPR level,duration of operation,intraoperative blood loss,the number of removed lymphatic nodes,postoperative activity time,postoperative aerofluxus time,postoperative days in hospital,the rate of postoperative complications were dynamically monitored and compared between the two groups.Results：Postoperative immune index of group A was better than that of group B.The amount of intraoperative blood loss,postoperative activity time,postoperative aerofluxus time,postoperative days in hospital and the rate of postoperative complicationsof group A were better than that of group B（P 0.05）.There was no significant difference in terms of duration of operation and the number of removed lymphatic nodes between the two groups（P 0.05）.Conclusion：Laparoscopic radical gastrectomy with combinations of FTS is of equal safety of traditional open surgery,and has obvious advantages in aspects of postoperative recovery and immune effect,which is helpful to recovery.