腹腔镜胃癌D2根治术在进展期胃癌中的应用探讨

Discussion on the application of operation in advanced gastric carcinoma in laparoscopic D2 radical gastrectomy

目的探讨腹腔镜胃癌D2根治术在进展期胃癌中的近期疗效。方法选择自2010年1月~2013年12月我院收治的胃癌患者中开腹54例按照常规的开腹手术进行胃切除术（开腹组）,而50例行腹腔镜胃癌D2根治术（腹腔镜组）,记录并比较术中、术后情况及术后并发症及病死率情况。结果腹腔镜组术中出血量、手术时间、住院时间及术后胃肠功能恢复时间均短于开腹组（P〈0.05）,两组胃癌术后病死率比较,差异无统计学意义（P〉0.05）。结论与传统开腹远端胃癌D2根治术相比,腹腔镜手术对于进展期胃癌的治疗能达到同样的根治性效果,与此同时其具有手术时间短、切口小、出血少、恢复快、安全可靠等优点,值得临床推广应用。

Objective To evaluate the clinical efficacy of laparoscopic D2 gastric cancer radical operation for advanced gastric carcinoma. Methods From January 2010 to December 2013 in our hospital 54 cases of patients with gastric cancer,gastrectomy in accordance with conventional were selected as open surgery（open group）, 50 cases with laparoscopic radical resection of gastric cancer D2（laparoscopic group）, the rate of surgery and postoperative complications and mortality situation in and after operation were recorded and compared. Results Volume, operation time, hospitalization time and postoperative gastrointestinal function recovery time in the laparoscopic group were shorter than open group（P〈0.05）,postoperative gastric cancer mortality rate of two groups had no significant difference（P〉0.05）. Conclusion Compared to conventional open distal gastric cancer D2, laparoscopic radical resection surgery in the treatment of advanced gastric cancer can achieve the same radical effect, meanwhile it has advantages of short operation time, small incision, less bleeding, quick recovery, safe and reliable, worthy of clinical popularization and application.