不同胃癌根治术治疗早期胃癌的疗效评价

Curative effect of different types of radical gastrectomy for the treatment of early gastric cancer.

目的观察不同胃癌根治术治疗早期胃癌的临床效果。方法对2009年9月至2011年9月采用开腹胃癌根治术(开腹组,n=50)和腹腔镜胃癌根治术(腹腔镜组,n=50)治疗的100例早期胃癌患者的临床资料进行回顾性分析。结果开腹组患者的手术时间为(221.89±54.27)min、术中出血量为(256.24±176.73)ml、术后进食半流食时间为(7.23±2.14)d、疼痛持续时间为(3.74±0.54)d、肛门排气时间为(4.19±1.37)h、住院时间为(12.49±0.57)d。腹腔镜组患者的手术时间为(193.16±52.54)min、术中出血量为(158.16±121.35)ml、术后进食半流食时间为(5.18±1.89)d、疼痛持续时间为(3.06±0.47)d、肛门排气时间为(2.13±1.26)h、住院时间为(10.23±0.46)d。腹腔镜组的手术时间、术中出血量、术后进食半流食时间、疼痛持续时间、肛门排气时间和住院时间差异均具有统计学意义(P<0.05);两组患者在肿瘤切缘、淋巴结清扫范围、清扫淋巴结数量、并发症、淋巴结转移和复发率方面差异均无统计学意义(P>0.05)。结论与开腹胃癌根治术比较,腹腔镜胃癌根治术治疗早期胃癌具有安全有效、创伤小、恢复快、住院时间短等优势,可以作为治疗早期胃癌的首选方法。

Objective To compare and analyze the curative effect and prognosis of different types of radical gastrectomy for the treatment of early gastric cancer. Methods The clinical data of 100 patients with early gastric cancer in our hospital from September 2009 to September 2011 was analyzed retrospectively, who were treated with open radical gastrectomy （open surgery group, n=50） or the laparoscopie radical gastrectomy （laparoscopic group, n=50）. Results The operation time, intraoperative bleeding, time of starting liquid diet, pain time, anorectum exhaust time, length of hospital stay were （221.89±54.27） min, （256.24±176.73） ml, （7.23±2.14） days, （3.74±0.54） days, （4.19±1.37） h, （12.49±0.57） days in the open surgery group, and （193.16±52.54） min, （158.16± 121.35 ） ml, （5.18± 1.89） days, （3.06±0.47） days, （2.13±1.26） h, （10.23±0.467） days in the laparoscopic group, respectively. Statistically significant difference was found between the two groups in the above-mentioned indexes （P〈0.05）. However, there were no sig- nificant difference in the tumor resection margins, extent of lymph node dissection, number of the lymph node dissec- tion, syndrome, lymphatic metastasis and recurrence rate between the two groups （P〉0.05）. Conclusion Compared with open radical gastrectomy, the laparoscopic radical gastrectomy for treatment of early gastric cancer has a lot of advantages, including good safety, high efficiency, minimal invasion, early recovery and short length of hospital stay, which can be chosen as the preferred method to treat early gastric cancer.