进展期胃癌应用腹腔镜与开腹胃癌D2治疗效果的研究

Study on the Effect of D2 Treatment of Advanced Gastric Cancer by Laparoscopy and Open Surgery

目的:探讨腹腔镜手术与传统开腹手术对进展期胃癌D2治疗的临床效果。方法:选取2012年1月-2013年5月于本院进行胃癌D2治疗的进展期胃癌患者100例作为研究对象,采用随机数字分配法将所有患者分为研究组和对照组,每组50例。研究组患者行腹腔镜手术,对照组患者行开腹治疗,观察分析两组患者术后各临床指标与并发症情况。结果:研究组患者术中出血量、切口长度及术后引流量均少于对照组,差异均有统计学意义(P<0.05),而两组手术时间和淋巴结清扫数量比较差异均无统计学意义(P>0.05);研究组患者术后下床活动时间和住院时间均短于对照组,比较差异均有统计学意义(P<0.05),而两组术后肠功能恢复时间和镇痛泵使用时间比较差异均无统计学意义(P>0.05);研究组患者术后并发症发生率为8.0%,明显低于对照组的24.0%,差异有统计学意义(字2=4.7619,P=0.0291)。结论:在进展期胃癌的D2根治手术过程中,腹腔镜手术治疗具有与传统开腹治疗相近的临床疗效,但腹腔镜治疗能够减少手术过程中的出血量、缩短住院时间,增加美观程度,此方法值得临床借鉴与推广。

Objective：To explore the clinical efficacy of laparoscopic surgery and traditional open surgery for the treatment of advanced gastric cancer with D2.Method：From January 2012 to May 2013,100 cases of D2 treatment advanced gastric cancer in our hospital were selected as the research objects,they were divided into the study group and the control group according to the random number assignment method,each group had 50 cases.The study group was treated with laparoscopic surgery and the control group was treated with open surgery,two groups of postoperative clinical indicators and complications were observed and analyzed.Result：The intraoperative blood loss,length of incision,postoperative drainage of the study group were significantly lower than those of the control group,the differences were statistically significant（P〈0.05）.There were no significant differences in the operation time and the number of lymph node dissection between two groups（P〈0.05）.The ambulation time and hospitalization time of the study group were less than those of control group,the differences were statistically significant（P〈0.05）,two groups of postoperative intestinal function recovery time and analgesic pump use time were not statistically significant（P〈0.05）. The incidence rate of postoperative complications in the study group was 8.0%,which was significantly lower than 24.0% of the control group,the difference was statistically significant（ χ^2=4.7619,P=0.0291）.Conclusion：In advanced gastric cancer D2 radical during surgery,laparoscopic surgery has similar clinical curative effect treated with traditional open surgery,but laparoscopic treatment can reduce the operation process in the amount of bleeding,shorten the hospitalization time and increase the degree of beauty.This method is worth of clinical reference and promotion.