腹腔镜辅助根治术用于胃癌伴肥胖患者的可行性及安全性分析

The feasibility and safety analysis of laparoscopic assisted radical therapy for obese patients with gastric cancer

目的:探讨腹腔镜辅助根治术用于胃癌伴肥胖患者的可行性及安全性。方法:按研究对象的选择标准,对我院2012年12月至2013年12月收治的胃癌伴肥胖患者予以筛选,选取符合标准的76例为研究对象。采用随机数字表法将其分为观察与对照组,观察组40例,采用腹腔镜辅助根治术;对照组36例,采用开腹手术。对比分析两组手术时间、术中出血量、清扫淋巴结数量、术中并发症、疗效、术后并发症、术后康复时间、治疗依从率等。结果:观察组手术时间、淋巴结清扫数量与对照组差异无统计学意义(P>0.05),出血量、切口长度、术后并发症发生率、排气时间、进食时间、出院时间等均优于对照组,差异有统计学意义(P<0.05);观察组总有效率为87.5%,对照组为88.9%,两组差异无统计学意义(P>0.05);观察组完全依从22例,依从16例,不依从2例,治疗依从率为95.0%,高于对照组的72.2%(P<0.05)。结论:腹腔镜辅助根治术用于胃癌伴肥胖患者具有出血少、并发症发生率低、疗效显著、依从性高等优势,安全可行。

Objective： To discuss the feasibility and safety of laparoscopic assisted radical therapy for obese patients with gastric cancer. Methods： According to selection criteria of the research object,obese patients with gastric cancer between Dec. 2012 and Dec. 2013 were screened,76 patients were selected as the research object. Patients were divided into observation and control group with random number table,40 patients in observation group were treated by laparoscopic assisted radical surgery; 36 patients in control group were treated with open operation. The operative time,intraoperative blood loss,harvested lymph node,intraoperative complications,curative effect,postoperative complications,postoperative recovery time,treatment compliance rate between two groups were compared and statistically analyzed. Results： The operative time and number of harvested lymph node were not significantly different between the two groups（ P＆＆＆＆＆0. 05）. The blood loss,length of incision,the incidence of postoperative complications,exhaust time,eating time,discharge time of observation group were superior to those of control group with significant difference（ P〈0. 05）. The total effective rate was87. 5% in observation group,and 88. 9% in control group,there was no significant difference（ P〉0. 05）. In observation group,there were 22 cases with full compliance,16 cases of compliance,2 cases of nonadherence,compliance rate of treatment was 95. 0%,which was higher than 72. 2% of the control group with significant difference（ P〈0. 05）. Conclusions： Laparoscopic assisted radical treatment for obese patients with gastric cancer is safe and feasible,has advantages of little blood loss,few complications,distinct curative effect and high compliance.