腹腔镜下远端胃癌根治术38例临床分析

Clinical Analysis on Laparoscopy-assisted Distal Gastrectomy in 38 Cases

目的:评价腹腔镜下远端胃癌根治术(LADG)治疗胃窦癌的临床推广价值。方法:采用随机对照研究,选择本院2011年12月-2013年12月76例胃窦癌患者,随机分为两组,研究组38例行腹腔镜下远端胃癌根治术,对照组38例采用传统开腹胃癌根治术,评价两组疗效及相关指标、并发症发生情况、术后复发情况等。结果:研究组平均住院时间及平均胃肠功能恢复时间均明显短于对照组(P<0.05);平均出血量明显少于对照组(P<0.05);平均切口长度短于对照组(P<0.05)。两组平均手术时间、清除淋巴结数目、并发症发生率比较差异无统计学意义(P>0.05)。所有患者均随访至2014年6月,研究组肝转移2例,对照组复发转移3例,死亡1例。结论:LADG安全可行,疗效肯定,创伤及副损伤小,值得临床推广应用,手术路径和淋巴清扫技术是手术成功的关键。

Objective：To evaluate the clinical spread value of laparoscopy-assisted distal gastrectomy（LADG） in treatment of gastric antral cancer.Method：76 patients with gastric antral cancer in our hospital from December 2011 to December 2013 were randomly divided into two groups,the 38 patients in the study were given laparoscopy-assisted distal gastrectomy,38 cases in the control group were given the conventional open gastrectomy,the curative effect,related indicators,complications, postoperative recurrence and hospitalization expenses were evaluated.Result：The average hospitalization time and average time of recovery of bowel activity were significantly shorter than the control group （P〈0.05）.The average amount of bleeding was significantly less than that of the control group（P〈0.05）.The average length of incision was shorter than that of the control group（P〈0.05）.The average operative time,mean number of resected nodes and complications between the two groups had no statistical differences.All the patients were followed up to June 2014,2 cases in the research group appeared hepatic metastasis;In the control group,3 cases appeared recurrence and 1 case was death.Conclusion：LADG is safe and feasible for the patients with gastric antral cancer,the curative effect is positive and there is less injury,so it is well worth popularizing.The operation path and lymph node dissection are the key steps to the success of the operation.