腹腔镜、开腹手术在胃癌根治术中的临床应用价值

Clinical application of laparoscopic radical gastrectomy via laparotomy in gastric cancer surgery

目的:探讨腹腔镜辅助下微创手术在胃癌根治术中的临床价值。方法:将215例胃癌患者纳入研究,105例腹腔镜手术为观察组,110例开腹手术为对照组,观察并比较两组近期指标及免疫功能指标。结果:两组患者的手术时间、切缘与病灶的距离、淋巴结清扫数目的差异无统计学意义(P>0.05);观察组的术中出血量、术后肛门首次排气时间、术后进食时间、镇痛药使用次数、总住院时间均少于对照组,差异有统计学意义(P<0.05);观察组患者术后7d各项免疫指标恢复到术前水平,对照组患者术后14d才恢复到术前水平,且观察组患者的各项免疫指标始终高于对照组。结论:与开腹手术相比,腹腔镜手术能够减小手术创伤,促进术后胃肠功能和免疫指标的恢复。

Objective= To evaluate the clinical value of laparoscopic assisted minimally invasive op- eration in gastric cancer surgery. Methods.. A total of 215 gastric cancer patients were enrolled in the stud- y, including 105 cases of laparoseopie operation as observation group and 110 cases of laparotomy as con- trol group. The perioperative indicators and immune parameters were observed. Results= There were no statistical significance difference in operation time, surgical margin, lymph node yield between these two groups the amount of bleeding, first flatus, postoperative feeding time, frequency of analgesics use and hospitalization time of the observation group were significantly less than those of control group~ the im- mune parameters of the observation group returned to the preoperative evels in the postoperative 7 d, while in the control group it was 14 d,and the immune parameters in observation group were always higher than those of the control group. Conclusion. Compared with laparotomy, laparoscopic radical gastrectomy can reduce surgical trauma and promote the recovery of postoperative gastrointestinal function and immune parameters.