腹腔镜远端胃癌D_2根治术在进展期胃癌中的临床应用价值

The clinical value of totally laparoscopic D_2 gastrectomy for advanced gastric cancer

目的:对比分析完全腹腔镜与开腹远端胃癌D_2根治术在进展期胃癌中的应用价值。方法:回顾性分析我院2013年1月至2014年12月收治的接受完全腹腔镜胃癌D_2根治手术的进展期胃癌患者40例(腹腔镜组)及接受开腹胃癌D_2根治手术的进展期胃癌患者36例(开腹组)的临床资料。对比分析两组的手术时间、术中出血量、术后肛门排气时间、术后住院时间、术后并发症、淋巴结清除数、肿瘤距远近切缘距离。结果:腹腔镜组手术时间明显较开腹组长,但术中出血量、术后肛门排气时间、术后住院时间均少于开腹组,差异均有统计学意义(P<0.05);两组术后并发症发生率、淋巴结清扫数目及两组远、近切端距肿瘤距离比较,差异无统计学意义(P>0.05)。结论:完全腹腔镜远端胃癌D_2根治术治疗进展期胃癌是安全、可行的,可以达到与开腹手术同样的根治效果。

Objective： To investigate the clinical value of totally laparoscopy D2 surgery for advanced gastric cancer totally laparoscopy and open the distal gastric D2 radical surgery. Methods： The clinical data of 40 patients with advanced gastric cancer received totally laparoscopy（ laparoscopy group） and 36 patients with advanced gastric cancer received open surgery（ open surgery） between January 2013 and December 2014 were analyzed. Clinical parameters including operation time,blood loss,first flatus time,postoperative hospital stay,complications,and the number of lymph nodes dissected length of proximal and distal margin to the cancer were observed. Results： The operation time was longer,volume of bleeding was less,first flatus time and postoperative hospital stay were shorter in laparoscopic group compared to those in open group（ P〈0. 05）. There were no significant differences between two groups in rate of complications,number of lymph nodes and length of proximal and distal margin to the cancer（ P〈0. 05）. Conclusion： Totally laparoscopic D2 gastrectomy is safe and feasible for advanced gastric cancer,and has similar radical effect compared with open surgery.