腹腔镜辅助与开腹胃癌根治术后近期康复研究

Postoperative short-term rehabilitation study of laparoscopic-assisted gastrectomy and open radical gastrectomy

目的比较腹腔镜辅助胃癌根治手术与传统开腹胃癌根治手术后患者早期临床康复情况。方法回顾性分析2012年6月至2013年3月46例腹腔镜辅助胃癌根治术（腹腔镜组）与85例开腹胃癌根治术（开腹组）患者的临床资料。结果腔镜组手术时间为（274±78）min，长于开腹组的（217±41）min，两组比较差异有统计学意义（P〈0．01）；腹腔镜组淋巴结清扫数目为（30．5±10．4）枚，开腹组为（32．6±12．3）枚，两组比较差异无统计学意义（P=0．339）。腹腔镜组术中出血量（254±112）ml、术后首次下床活动时间（63±16）h、术后胃肠道功能恢复时间（77±20）h、术后首次进食时间（88±15）h、术后住院时间（11．1±4．6）d，均明显优于开腹组，两组比较差异有统计学意义（P〈0．05）。结论腹腔镜辅助胃癌根治手术可行，同时具备手术视野清晰、创伤小、术中出血少、术后恢复快和术后住院时间短等优点，患者近期康复效果优于开腹手术。

Objective To compare the postoperative short-term rehabilitation of laparoscopic-assisted gastrectomy and open radical gastrectomy for gastric cancer. Methods The clinical data of 46 eases of laparoscopic-assisted radical gastrectomy （ laparoscopic group） and 85 cases of open radical gastreetomy （open group） from June 2012 to March 2013 were analyzed retrospectively. Results Compared with open group, the operation time was longer in laparoscopic group [ （274 ± 78 ）rain vs （217 ±41）min, P〈0.01]. The number of lymph node disseetions was （30.5 ±10.4） inlaparoseopie group and（32.6 ±12.3 ） in open group, there was no significant difference（ P = 0. 339 ）. Estimated blood loss in the laparoscopic group [ （254 ± 112）ml] was significantly less than that in the open group （ P 〈 0.001 ）. First postoperative ambulation time was （ 63 ± 16） hours, gastrointestinal function recovery time was （ 88 ± 15 ） hours, first postoperative feeding time was （ 88 ±15 ） hours, postoperative hospital stay was（ 11.1 ±4.6） days in the laparoscopic group, they were shorter than those in the open group（P 〈 0.05 ）. Conclusions Laparoscopic-assisted radical gastrectomy for gastric cancer is feasible, and it has such advantages such as clear vision surgery, minimally invasion, less bleeding, rapid postoperative recovery, and shorter postoperative hospital stay.