腹腔镜胃癌根治术与开腹手术对进展期胃癌的影响

Effects of Laparoscopic Gastrectomy and Open Gastrectomy for Advanced Gastric Cancer

目的:探讨腹腔镜胃癌根治术与开腹手术对进展期胃癌患者手术治疗的影响。方法:回顾性研究分析本院2010年1月-2012年2月收治的22例腹腔镜胃癌D2根治术患者和36例开腹手术患者的临床资料,比较两组手术时间、手术切口长度、术中出血量和输血率、清扫淋巴结数目、阳性淋巴结数目和血生化指标等,探讨两者在手术安全性和可行性方面的差异。结果:与开腹手术相比,腹腔镜手术时间较长(P<0.05),手术切口长度、术中出血量、输血率、白细胞水平和C-反应蛋白水平明显降低(P<0.05),清扫淋巴结数目、阳性淋巴结数目、切缘阳性率、术后并发症无明显差异(P>0.05)。结论:腹腔镜胃癌根治术能够达到与开腹手术相同的治疗效果,并且具有创伤小、出血少、手术风险小和术后恢复快等优势。

Objective： To investigate the effects of laparoscopic gastrectomy and open gastrectomy for advanced gastric cancer.Method：This article retrospective analyzed clinical datas of 22 cases underwent laparoscopic advanced gastric cancer patients and 36 cases underwent open gastrectomy between January 2010 and February 2012.The two groups’ operation time,peri-operative bleeding,incision length,lymph node dissection number,postoperative complications were recorded,to discuss the superior and inferior between gastric cancer underwent laparoscopic and open gastrectomy. Result：Operation time of laparoscopic group was longer than that of open group（P〈0.05）.And peri-operative bleeding, incision length in laparoscopic group were significantly less than those in open group（P〈0.05）.Blood transfusion rate of laparoscopic group was less than that of open group（P〈0.05）.There were no differences in lymph node dissection number,postoperative complications between laparoscopic gastrectomy and open gastrectomy.Conclusion：Compared with open gastrectomy,laparoscopic gastrectomy with D2 lymphadenectomy is a feasible and safe procedure and has several advantages in less bleeding,smaller incision and risk,quicker recovery.