单中心腹腔镜辅助与开腹远端胃癌D2根治术的临床对比报告

Clinical comparative study of laparoscopic-assisted and open radical surgery for distal gastric cancer

目的比较腹腔镜辅助远端胃癌D2根治术与开腹远端胃癌D2根治术疗效、安全性及应用价值。方法回顾性分析2010年7月～2011年10月在我院行远端胃癌根治术80例患者资料，其中腹腔镜辅助远端胃癌根治手术35例（腹腔镜组），与同期开腹远端胃癌根治手术45例（开腹组）对比分析腹腔镜组与开腹组病人术中和术后情况、并发症及近期生存差异。结果腹腔镜组与开腹组一般资料、肿瘤位置、病理学分化类型、转移淋巴结数目、清扫淋巴结数目、肿瘤浸润深度、肿瘤TNM分期、术中出血、术后并发症、近期生存率差异无统计学意义（P〉0．05），腹腔镜组手术时间长于开腹组（P〈0．05），腹腔镜组切口长度、术后下床活动、术后排气时间、术后进食时间、术后住院时间均少于开腹组，差异有统计学意义（P〈0．05）。结论腹腔镜辅助胃癌D2根治手术是安全可行的，能达到开腹手术同样的根治效果，具有创伤小、术后恢复快等优势。

Objective To evaluate the safety and value of laparoscopic radical resection of dis- tal gastric cancer with D2 lymph node dissection and compare its efficacy with open radical sur- gery. Methods Clinical data of 80 patients with distal gastric cancer underwent radical gas- trectomy in our hospital from July 2010 to October 2011 were retrospectively analyzed. Among the patients, 35 cases were given laparoscopic assisted radical distal gastrectomy （laparoscopic group ） and 45 cases were given open distal gastrectomy （ open surgery group） in the same peri- od. The differences of intraoperative and postoperative situation, postoperative complications and short-term survival rates between laparoscopy and open surgery group were analyzed： Results Laparoscopic surgery group with open surgery group had no statistically significant differences in gender, age, tumor location, tumor diameter, grade of differentitation, number of lymph node metastasis, number of lymph nodes dissection, depth of tumor invasion, TNM staging, blood loss, postoperative complications and short-term survival rate. The operative time of the ]aparo- scopic group was significantly longer than that of the open group （ P 〈 0. 05 ）, the length of inci- sion, postoperative ambulation time, postoperative exhaust time. oostooerative ealln~ tirn,~hospital stay were shorter after open surgery group, which showed statistically significant differ- ences compared with open surgery group （P 〈 O. 05）. Conclusion Laparoscopic radical gas- trectomy is safe, procedure and matches the results of open surgery, but postoperative recovery fast and less invasive.