胃癌D2根治术采取手辅助腹腔镜治疗的临床干预评价

Evaluation on effect of clinical intervention in D2 lymphadenectomy for gastric cancer combined with hand-assisted laparoscope

目的研究胃癌D2根治术采取手辅助腹腔镜治疗的临床效果。方法抽选84例符合相关纳入标准的胃癌患者为此次研究观察对象,随机分为对照组与研究组,各包含42例,术式的选择2组有所不同,前者是腹腔镜胃癌D2根治术,后者施以手辅助腹腔镜胃癌D2根治术,术毕将围手术指标、手术切除根治性指标及术后并发症等方面对手术疗效予以评析。结果研究组的切口长度明显更长(P<0.05),手术耗时明显更短(P<0.05),而2组在术中失血量、肛门排气时间及住院时间等上无明显差异(P>0.05);研究组的淋巴结清扫数明显更多(P<0.05),而2组在近端切缘距肿瘤长度以及远端切缘距肿瘤长度等上无明显差异(P>0.05);对照组的术后并发症发生率为26.2%,相比之下研究组的明显更低,为7.1%(P<0.05)。结论胃癌D2根治术采取手辅助腹腔镜治疗所取得临床效果与腹腔镜手术相当,但前者具有手术耗时短、操作难度低及并发症少等优势。

Objective To study the clinical effect of D2 lymphadenectomy for gastric cancer combined with hand-assisted laparoscope. Methods 84 patients with gastric cancer who met the inclusion criteria were selected as the research object and they were randomly divided into the control group and research one, with 42 cases in each group. Patients in both groups were given with the different operations, where one in the control group were given with D2 lymphadenectomy for gastric cancer combined with laparoscope and one in the research group were given with D2 lymphadenectomy for gastric cancer combined with hand-assisted laparoscope. The curative effect was evaluated and analyzed in the aspects of perioperative indicators, radical resection indicators and postoperative complications. Results The length of incision for patients in the research group was significantly longer （P〈0.05）, with the shorter operation time （P〈0.05）. There was no significant difference in the intraoperative blood loss, flatus time and length of stay between two groups （P〉0.05）. The number of lymph node dissection for patients in the research group was significantly higher （P〈0.05）, but there was no significant difference in the length of proximal margin and the length of distal margin between two groups （P〉0.05）. The incidence of postoperative complications for patients in the control group was 26.2%, which was significantly higher than that of 7.1% in the research group （P〈0.05）. Conclusion The clinical effect of D2 lymphadenectomy for gastric cancer with hand-assisted laparoscope is similar to the one with laparoscope, but the former one has the advantages of short operation time, low difficulty and little complications.