腹腔镜D2根治术治疗进展期胃癌的近期疗效分析

Short-term efficacy analysis of laparoscopic D2 radical gastrectomy for advanced gastric cancer

目的:探讨腹腔镜与开腹胃癌根治术治疗进展期胃癌的近期疗效。方法:回顾分析手术治疗的89例进展期胃癌患者的临床资料,其中46例行腹腔镜下胃癌根治术(腹腔镜组),43例行传统开腹胃癌根治术(开腹组),対比分析两种术式的优缺点。结果:腹腔镜组与开腹组手术时间[(188.37±9.50)min vs.(167.33±6.76)min]、术中失血量[(65.54±6.34)ml vs.(111.05±14.74)ml]、术后排气时间[(59.74±14.86)h vs.(82.88±15.45)h]、术后进食时间[(61.93±14.90)h vs.(84.91±15.42)h]、术后镇痛药应用次数[(2.87±1.15)vs.(4.12±1.07)]及术后住院时间[(12.28±1.63)d vs.(15.28±0.77)d]等方面差异有统计学意义(P<0.05);术后并发症发生率[2(4.35%)vs.5(11.63%)]、清扫淋巴结数量[(25.87±1.22)枚vS.(25.91±1.11)枚]差异无统计学意义(P>0.05)。结论:腹腔镜下D2根治术治疗进展期胃癌是安全、可行的,相较传统开腹手术存在多方面优势。

Objective：To evaluate the short-term curative effect of laparoscopic and open D2 radical gastrectomy in treatment of advanced gastric cancer.Methods：Clinical data of 89 patients who were diagnosed as advanced gastric cancer and performed D2 radical gastrectomy in the past two years were retrospectively analyzed.Among them,46 patients were treated by laparoscopic D2 radical gas—trectomy,named laparoscopic group.43 cases were treated by conventional open D2 radical gastrectomy,named open group.The advantages and disadvantages of the two methods were compared and studied in many aspects.Results：Average time of operations[（188.37±9.50） min vs.（167.33±6.76） min],intraoperative blood loss[（65.54±6.34） ml vs.（111.05±14.74） ml]postoperative exhaust time[（59.74±14.86） h vs.（82.88±15.45） h]postoperative feeding time[（61.93±14.90） h vs.（84.91±15.42）h]frequency of postoperative analgesic[（2.87±1.15） vs.（4.12±1.07）]and average postoperative hospitalization time[（12.28±1.63） d vs.（15.28±0.77） d]showed significant differences between laparoscopic group and open group（P〈0.05）.There was no significant difference in postoperative complications[2（4.35%） vs.5（11.63%）]and number of lymph node dissected[（25.87±1.22） vs.（25.91±1.11）]between laparoscopic group and open group（P 〉 0.05）.Conclusions：Laparoscopic D2 radical gastrectomy for advanced gastric cancer at the operational level is safe and feasible.