腹腔镜与开腹远端胃癌D2根治术的对比研究

Comparative study of laparoscope and laparotomy D2 radical gastrectomy in the treatment of distal gastric cancer

目的通过对比腹腔镜与开腹远端胃癌D2根治术的疗效及安全性,探讨腹腔镜辅助远端胃癌D2根治术的临床价值。方法 221例行远端胃癌D2根治术患者,分为两组。其中腹腔镜组115例,开腹组106例,对两组手术时间、术中出血量、术后排气时间、首次进流质时间、淋巴结清扫数目、术后住院天数、并发症进行比较。结果腹腔镜组手术时间、淋巴结清扫数与开腹组差异无统计学意义(P>0.05),而腹腔镜组术中出血量少,术后肛门排气时间早,首次进流质时间早,术后住院时间短,并发症发生率低(P<0.05)。结论腹腔镜辅助远端胃癌D2根治术具有创伤小、出血少、术后恢复快和并发症少等优点,近期疗效与开腹手术相当,安全可行,值得临床推广。

Objective To explore the clinical value of laparoscope assisted D2 radical gastrectomy for distal gastric cancer by comparing the curative effects and safety of laparoscope and laparotomy D2 radical gastrectomy. Methods A total of 221 cases of distal gastric cancer underwent D2 radical gastrectomy were divided into two groups as laparoscope group （n=llS） and laparotomy group （n=106）. The operation time, intraoperative bleeding volume, postoperative exhaust time, first time of liquid diet, number of lymph node cleaning, postoperative hospital stays, and complications were compared between the two groups. Results There were no significant differences of operation time, number of lymph node cleaning, and complications between the laparoscope group and laparotomy group （P〉0.05）. However, the laparoscope group had fewer intraoperative bleeding volumes, earlier postoperative anal exhaust time, earlier first time of liquid diet, shorter postoperative hospital stays and lower incidence of complications （P〈0.05）. Conclusion Laparoscope assisted D2 radical gastrectomy in the treatment of distal gastric cancer has small trauma, few bleeding, quick recovery and less complications. The recent curative effect is similar as that of laparotomy, and the treatment is safe and feasible, and worthy of clinical vromotion.