腹腔镜远端胃癌D2根治术的临床分析

Clinical Analysis of Laparoscopic D2 Radical Distal Gastrectomy for Gastric Cancer

目的探讨腹腔镜远端胃癌D2根治术治疗胃癌的疗效。方法对64例胃癌患者分别采用腹腔镜远端胃癌D2根治术(腹腔镜组,n=33)和开腹远端胃癌D2根治术(开腹组,n=31)治疗,然后分析2组患者的临床资料。结果2组患者的淋巴结清扫数、肿瘤上切缘长度、肿瘤下切缘长度都无显著差异(P>0.05)。腹腔镜组患者在术中出血量、切口长度、胃管拔除时间、排气时间、进食流质时间、下床活动时间、住院时间、止痛剂注射次数以及并发症等方面均显著好于开腹组患者(P<0.05)。但是腹腔镜组患者的手术时间显著长于开腹组患者(P<0.05)。结论腹腔镜胃癌D2根治术创伤小、淋巴结清扫彻底、患者反应轻、术后恢复快,能达到肿瘤根治原则,值得在临床推广应用。

Objective To study the efficacy of laparoscopic 192 radical distal gastrectomy for gastric cancer. Methods 64 patients with gastric cancer were divided into the laparoscopy group（ n = 33, treated with laparoscopic D2 radical distal gastrectomy） and the open surgery group（ n = 31 ,treated with open D2 radical distal gastrectomy）. Clinical data of the 2 groups were ret- rospectively analyzed. Resdts The number of lymph node cleaning,length of up-cutting and down-cutting margin of tumor had no significant difference （ P 〉 0.05 ）. The peri-operative bleeding, length of incision, extubation time, time for anal exhaust, time for dieting, time for getting up and exercising, hospitalization time, analgesic injections, and complications of the laparoscopy group were significant better than those of the open surgery group （P 〈 O. 05 ）. However, the operation time of the laparoscopy group was significant longer than that of the open surgery group（ P 〈 0.05 ）. Conclusion The laparoscopic D2 radical distal gastrectomy for gastric cancer has the virtues of smaller trauma, complete lymph node dissection, less complication and early recovery. It is worthy of clinical promotion.