腹腔镜辅助进展期胃癌根治术的临床体会

Clinical Experience in Progressive Laparoscopic-assisted Radical Correction of Gastric Cancer

目的:探讨进展期胃癌行腹腔镜辅助手术的安全性和可行性并评价临床近期疗效。方法:选择2011年1月至2013年6月30例进展期胃癌患者行腹腔镜辅助胃癌根治术患者(腹腔镜组),与同期28例行传统开腹胃癌根治手术的患者(开腹组)比较两组患者的手术时间、出血量、清扫淋巴结数目、术后胃肠道功能恢复情况、并发症发生率、住院平均时间等情况。结果:腹腔镜组手术时间长于开腹组,两组间差异有统计学意义(t=4.635,P<0.05);腹腔镜组术中出血量、肛门首次排气时间、术后住院时间明显优于开腹组;腹腔镜组淋巴结清扫数量为(25.5±8.5)枚,开腹组为(20.6±7.8)枚,两组比较差异无统计学意义(P>0.05)。腹腔镜组术后并发症发生率(6.7%)及死亡率(0)均低于开腹组,但差异无统计学意义。患者随访时间6个月,两组患者总体生存率差异无统计学意义(P>0.05)。结论:腹腔镜辅助进展期胃癌根治术不仅创伤小,恢复快,具有安全性,而且能够达到与开腹手术相同的根治水平,其近期生存率与传统开腹手术无差别。

Objective： To investigate the safety and feasibility of progressive gastric cancer undergoing laparoscopic-assisted surgery, and evaluate the clinical curative effect. Methods：select 30 cases of progressive gastric cancer patients undergoing laparoscopic-assisted surgery from January 2011 to June 2013（laparoscopic group）, and 28 cases traditional laparotomy patients（open group） in the same period. Two groups were compared operative time, blood loss, number of lymph node dissection and postoperative recovery of gastrointestinal function, complications, average time of hospitalization. Results： operative time of Laparoscopic surgery group longer than laparotomy group, which was statistically significant（t=4.635, P〈0.05）; In laparoscopic group blood loss, anal exhaust time, postoperative hospitalization were significantly better than the laparotomy group; number of laparoscopic lymphadenectomy group（25.5 ±8.5） medals, laparotomy group（20.6 ±7.8） medals, two groups showed no significant difference（P〉0.05）. The incidence of postoperative complications in the laparoscopic group（6.7%） and mortality（0） were lower than the laparotomy group, but the difference was not statistically significant.Patients were followed up for 6 months, the overall survival rate between the two groups was not statistically significant（P〉0.05）. Conclusions： Laparoscopic-assisted radical correction of gastric cancer have the advantages：fewer traumas, quicker recovery, with security, the same radical laparotomy effect, and no difference in survival with the traditional surgery.