腹腔镜与开放手术行胃癌根治术临床疗效分析

Comparison of clinical curative effect of laparoscopic gastrectomy and open gastrectomy for gastric cancer

目的 探讨腹腔镜辅助下行胃癌根治术的安全性及可行性.方法 回顾性分析我科2011年1月至2012年12月同期收治的胃癌需手术治疗患者107例临床资料,分为腹腔镜组（50例）和开腹组（57例）,对比分析两组手术患者手术及术后情况.结果 两组患者均没有死亡病例,手术时间腹腔镜组为（293.24±54.49） min,开腹组为（217.34-38.65） min（P ＜0.01）,与开腹组比较,腹腔镜组术中出血量、术后胃肠功能恢复时间、下床活动时间及住院时间的差异有统计学意义（P＜0.05）,两组患者术后淋巴结清除个数分别为21.73枚和23.15枚,术后早期并发症在两组无明显区别.结论 腹腔镜胃癌D2根治术是安全可行的,与开腹手术相近根治效果,且具有术后恢复迅速、创伤小等优点.

Objective To investigate safety and feasibility of laparoscopy-assisted gastrectomy for gastric cancer. Methods A retrospective analysis of 107 cases of gastric cancer from January 2011 to De- cember 2012 was made; the patients were divided into laparoscopy group （n = 50 ）and laparotomy group （ n = 57 ）. The intraoperative and postoperative conditions were compared between the groups. Results No death occurred in groups. The operation time was （ 293.24 -＋ 54.49 ） rain in the laparoscopy grouop and （217.34 ~ 38.65 ）min in the laparotomy group（ P 〈 0.01 ）. The differences in intraoperative blood loss, postoperative gastrointestinal recovery time, ambulation time and hospital stay were significant between the groups（P 〈 0.05 ）. The numbers of dissected lymph nodes were 21.73 and 23.15 respectively. There was no significant difference in complication between the groups. Conclusion The laparoscopic gastrectomy with D2 lymphadenectomy is safe and reliable in the treatment of gastric cancer,which has the advantages of quick recovery and minor trauma.