腹腔镜与传统开腹胃癌根治术治疗胃癌的临床对照研究

Clinical controlled study on laparoscopic and conventional resections for radical gastric cancer surgery

目的对比研究腹腔镜胃癌根治术与传统开腹胃癌根治术治疗胃癌的临床疗效。方法 66例胃癌患者,根据手术方式分为腹腔镜组(给予腹腔镜下胃癌根治术)与传统开腹组(给予传统开腹胃癌根治术),每组33例。观察对比两组患者的术中出血量、胃肠道恢复时间、住院时间、手术时间及1年无瘤生存率、并发症发生率、远处转移率。结果腹腔镜组患者的术中出血量、胃肠道恢复时间、住院时间均少于传统开腹组,但手术时间长于传统开腹组,差异均具有统计学意义(P<0.05)。腹腔镜组患者1年无瘤生存率90.91%、并发症发生率9.09%、远处转移率3.03%,均优于传统开腹组的66.67%、30.30%、24.24%,差异有统计学意义(P<0.05)。结论腹腔镜胃癌根治术较传统开腹手术临床疗效较为显著,可显著改善患者的术中出血量、胃肠道恢复时间、住院时间等指标,可在临床推广和应用。

Objective To compare and research on clinical effect of laparoscopic radical gastrectomy and conventional resections in treating gastric cancer. Methods A total of 66 gastric cancer patients were divided by surgical methods into laparoscopic group（received laparoscopic radical gastric cancer surgery） and conventional group（received conventional resections）, with 33 cases in each group. Comparison were made on intraoperative blood loss, recovery time of gastrointestinal tract, length of stay, operative time, incidence of disease-free survival, complications and distant metastasi in 1 year between two groups. Results The laparoscopic group had less intraoperative blood loss, recovery time of gastrointestinal tract, length of stay than conventional group, and long operative time than conventional group, all differences had statistical significance（P〈0.05）. The laparoscopic group had incidence of disease-free survival, complications and distant metastasis in 1 year as 90.91%, 9.09%, and 3.03%, which were higher than 66.67%, 30.30%, and 24.24% than conventional group, and all differences had statistical significance（P〈0.05）. Conclusion Compared with conventional resections, laparoscopic radical gastric cancer surgery shows significant clinical effect in improving intraoperative blood loss, recovery time of gastrointestinal tract, length of stay, and this method is worth clinical ptomotion and application.