腹腔镜辅助远端胃癌D_2根治术治疗无浆膜层侵犯的进展期胃癌54例

Laparoscopic-assisted Distal Gastric Cancer of D_2 Radical Gastrectomy in Treatment of 54 Advanced Gastric Cancer Patients without Serosal Invasion

目的探讨腹腔镜远端胃癌D2根治术治疗无浆膜层侵犯的进展期胃癌的效果、可行性及安全性。方法选取2010年3月—2014年3月上海嘉定区中心医院收治的无浆膜层侵犯的胃癌108例,按手术方式分为观察组和对照组,每组54例。观察组行腹腔镜辅助远端胃癌D2根治术,对照组行开腹手术,比较两组手术相关指标及肿瘤根治性指标,观察两组并发症发生情况。结果观察组手术时间长于对照组,术中出血量少于对照组,术后胃肠道功能恢复时间短于对照组(P<0.05);两组重建方式、淋巴结清扫数目、浸润深度、临床分期、肿瘤分期、并发症发生率及无瘤生存率比较差异无统计学意义(P>0.05)。结论腹腔镜辅助远端胃癌D2根治术治疗无浆膜层侵犯的进展期胃癌创伤轻、恢复快、疗效好,安全可行。

Objective To investigate the effect,feasibility and safety of laparoscopic-assisted distal gastric cancer of D2 radical gastrectomy in treatment of advanced gastric cancer patients without serosal invasion. Methods A total of 108 advanced gastric cancer inpatients without serosal invasion during March 2010 and March 2014 were recruited in this study,and were divided into observation group（ n = 54） and control group（ n = 54） according to the operative methods. The observation group underwent laparoscopic-assisted distal gastric cancer of D2 radical gastrectomy,while the control group underwent open radical operation. The correlative indexes of operation and radical cure of tumor were compared,and the incidence rates of complications in the two groups were observed. Results In the observation group,the operation time was longer,intraoperative bleeding volume was less,and postoperative recovery time of gastrointestinal function was shorter than those in the control group（ P〈0. 05）; the differences in reconstruction methods,number of lymph node dissection,invasive depth,clinical stage,tumor staging,the incidence rate of complications and tumor free survival rate were not statistically significant in the two groups（ P〉0. 05）. Conclusion Laparoscopic-assisted distal gastric cancer of D2 radical gastrectomy in treatment of advanced gastric cancer patients without serosal invasion is less invasive,effective and safe with quicker recovery.