腹腔镜与开腹胃癌根治术的临床对比研究

Clinical study of laparoscopic gastric surgery and open gastrectomy surgery

目的：观察腹腔镜与开腹胃癌根治术的临床疗效，比较两种手术方式的优缺点。方法：2007年7月－201O年12月就诊于吉林大学第二医院普外科并经病理证实的57例胃癌手术患者进入研究，27例患者行腹腔镜胃癌根治术（LGS），30例患者行标准开腹胃癌根治术（OGS）。统计并分析患者一般临床资料、手术方式、淋巴结清扫情况、肿瘤复发及生存情况。结果：LGS组患者无中转开腹病例。57例患者中53例获得随访，4例失访，随访10—55个月，平均随访时间23个月。两组患者一般临床资料、手术方式、淋巴结清扫范围、清扫数目差异无统计学意义。结论：LGS和OGS治疗胃癌均可获得相似的长期临床结果。对于晚期胃癌，尤其是出现超过第2站淋巴结转移或者周围脏器受累的患者，LGS没有必要作为常规选择手段。

Objective： To observe the laparoscopic and open radical gastrectomy clinical effi- cacy, the advantages and disadvantages comparing two surgical methods. Methods： From July 2007 to December 2010 57 cases of gastric cancer in General Surgery Department in Second Hospi- tal of Jilin University, who were confirmed pathologically, 27 patients underwent laparoscopic gastric surgery （LGS）, 30 patients underwent standard open gastrectomy surgery OGS. Clinical data of patients, surgical approach, lymph node dissection cases, tumor recurrence and survival were anal-ysised. Results： LGS patients without transfer to open gastrectomy surgery. 53 patients were followed up in 57 cases, four cases were lost. Follow-up time was 10 to 55 months, with an average follow-up time of 23 months. No significant difference was found in two groups of patients clinical data, surgical approach, lymph node dissection. Conclusion： LGS and OGS treatment of gastric cancer can achieve similar long-term clinical outcomes. For advanced gastric cancer, especially over the first two stations appear or surrounding lymph nodes in patients with organ involvement, LGS is not necessary as a routine selection tool.