腹腔镜辅助进展期胃癌D2根治术与开腹手术近期疗效的临床对照研究

Controlled Clinical Study on Laparoscopic Assisted and Open D2 Radical Resection for Advanced Gastric Cancer

目的探讨腹腔镜辅助与传统开腹手术治疗进展期胃癌的近期疗效。方法对2010年10月至2012年10月期间因胃癌在笔者所在医院普外中心行腹腔镜辅助胃癌D2根治术(腹腔镜组,76例)和同期行传统开腹胃癌D2根治术(开腹组,104例)患者的临床资料进行回顾性分析,比较2组患者的手术相关指标、术后恢复情况和肿瘤根治程度。结果腹腔镜组的手术时间为(192.5±14.8)min,长于开腹组的(171.5±16.5)min(P<0.05);但腹腔镜组术中出血量、术后引流量、手术切口长度及住院时间则少于或短于开腹组(P<0.05)。术后并发症发生率及肿瘤根治程度2组间的差异无统计学意义(P>0.05)。2组均无切缘癌残留和手术死亡病例。结论腹腔镜辅助进展期胃癌D2根治术,能达到与开腹手术相当的临床近期疗效,且微创优势明显。

Objective To evaluate the curative effect of laparoscopic assisted and open D2 radical resection in treatment of advanced gastric cancer. Methods The clinical data of 76 cases performed by laparoscopic assisted D2 radical resection （laparoscopic group） and 104 cases performed by open operation （open group） from October 2010 to October 2012 in our center were retrospective analized. Operation related index, postoperative recovery, and extent of radical resection of tumor of 2 groups were compared. Results The operative time of the laparoscopic group [（192.5 ± 14. 8） min] was longer than that open group[ （171.5± 16. 5） min, P〈0. 05]. But the blood loss, postoperative drainage, length of incision, and hospital stay of the laparoscopic group were significantly less or shorter than those of open group （P〈 0. 05）. There were no significant difference in postoperative complications and extent of radical resection of tumor between the 2 groups （P〉0. 05）. There were no residual tumor in distal margin and operatiive death case in both 2 groups. Conclusion Comparing with open operation, the laparoscopic assisted surgery for advanced gastric cancer could achieve the same clinical outcomes, and obvious advantage of minimal invasion.