腹腔镜与开腹胃癌根治术的前瞻性对照研究

A Proactively Controlled Study Between Laparoscopic Radical Gastrectomy and Open Radical Gastrectomy

目的对比分析腹腔镜与开腹胃癌根治术的临床疗效。方法将该院收治的120例行胃癌根治术患者,按照治疗方法分组行前瞻性对照研究,分为腹腔镜组与开腹组,每组均60例,两组患者治疗后随访观察治疗效果。结果腹腔镜组切口长度、出血量、手术时间、住院时间,分别为(5.5±1.2)cm、(61.1±31.2)mL、(249±49)min、(9.0±6.5)d,与开腹组相比,差异有统计学意义(P<0.05),而淋巴结清扫个数对比,差异无统计学意义(P>0.05);两组患者均得到随访,腹腔镜组的复发率、转移率、病死率分别为5.0%(3例)、5.0%(3例)、6.7%(4例),与开腹组相比,差异无统计学意义(P>0.05)。结论腹腔镜胃癌根治术与开腹术相比,创伤更小、恢复更快,且不影响胃癌根治度,在短时期内,不会显著增加转移率、复发率与病死率,值得临床推广。

Objective To compare and analyze the clinical curative effect between laparoscopic radical gastrectomy and open radical gastrectomy. Methods 120 cases of gastric cancer patients underwent gastrectomy of stomach neoplasms in our hospital were divided into laparoscopic group and laparotomy group, 60 cases in each group, according to different treatment they received. We followed up two groups of patients after treatment for observing the treatment effect. Results The length of incision, blood loss, operative time and hospital stay of laparoscopic group were （5.5±1.2） cm, （61.1±31.2）mL, （249±49）min and （9.0±6.5）d orderly. Compared with those of the laparotomy group, the differences had statistical significance （all P〈0.05）. But the difference of number of lymph node cleaning had no statistical significance （P〉0.05）. All the patients of two groups were followed up. The recurrence rate, transfer rate and fatality rate of laparoscopic group was 5.0%（3 cases）, 5.0%（3 cases） and 6.7%（4 cases） orderly. Compared with those of the laparotomy group, the differences had no statistical significance （all P〉0.05）. Conclusion Compared with open radical gastrectomy, laparoscopic radical gastrectomy has less trauma and faster recovery without affecting the completeness of gastric cancer resection, and does not significantly increase transfer rate, recurrence rate and fatality rate in a short period of time, which is worthy of further clinical promotion.