腹腔镜与开腹胃癌根治术幽门下淋巴结清扫的临床疗效分析

Feasibility and short term outcome of No.6 lymph nodes dissection for gastric cancer:laparoscopic vs open gastrectomy approach

目的探讨腹腔镜对胃癌根治术中第6组淋巴结清扫的可行性。方法选取2014年1-12月于解放军总医院普通外科行胃癌根治术的患者380例,其中腹腔镜胃癌根治术97例,开腹胃癌根治术283例,对两组患者围术期相关指标及随访情况等进行回顾性分析。结果两组患者年龄、性别、术后病理分期、第6组淋巴结清扫数目等差异均无统计学意义(P>0.05)。但腹腔组第6组淋巴结清扫时间长于开腹组[(25.85±2.26)min vs(18.72±3.62)min,t=22.24,P<0.001]。随访6~18个月两组均未见局部复发。结论对于有丰富腹腔镜手术经验的术者,腹腔镜胃癌根治术行第6组淋巴结清扫是安全可行的。

Objective To explore the feasibility and short term outcome of No.6 lymph nodes dissection for gastrectomy via laparoscopic versus laparotomic approach.Methods Three hundred and eighty patients who underwent gastrectomy in Chinese PLA General Hospital from January 2014 to December 2014 were identified.Ninety-seven of them were treated by laparoscopic resection,and the rest of the cases underwent laparotomy.The perioperative condition and follow-up data of two groups were retrospectively compared.Results No significant difference was found in age,gender,postoperative pathologic staging results,the number of dissected No.6 lymph nodes between two groups（P〉0.05）.However,laparotomy was superior to laparoscopic resection in operating time[（18.72±3.62） min vs（25.85±2.26） min,P〈0.001].Meanwhile,local recurrence was not observed during the short-term follow-up of 6-18 months.Conclusion No.6 lymph nodes dissection in laparoscopic gastrectomy is safe and feasible when operated by experienced surgeons.