腹腔镜D2根治术治疗进展期胃癌的疗效观察

Efficacy of laparoscopic D2 radical gastrectomy for advanced gastric cancer

目的探讨腹腔镜D2根治术治疗进展期胃癌的疗效及并发症。方法选取2014年3月至2016年1月间攸县人民医院收治的64例进展期胃癌患者,采用随机数表法分为观察组与对照组,每组32例。观察组患者采用腹腔镜D2根治术,对照组患者采用传统开腹远端胃切除术。比较两组患者手术相关指标、术后1个月机体功能恢复情况、并发症发生率及1年生存率。结果观察组患者手术切口长度和手术用时少于对照组患者,差异均有统计学意义(均P<0.05)。观察组患者肛门排气时间、下床活动时间、开始进食时间、住院时间及术后胃部出血量均少于对照组患者,差异均有统计学意义(均P<0.05)。观察组患者并发症发生率为12.5%,低于对照组患者的37.5%,差异有统计学意义(P<0.05)。两组患者1年生存率比较,差异无统计学意义(P>0.05)。结论采用腹腔镜D2根治术治疗进展期胃癌患者疗效显著,可减少手术用时和术后胃部出血量,促使患者康复,降低疾病病死率,安全性较高。

Objective To explore the efficacy of [aparoscopic D2 gastrectomy for advanced gastric cancer and the associated complications. Methods From March 2014 to January 2016, 64 patients with advanced gastric cancer treated at You County People＇s Hospital were selected and randomly divided into an observation group and a control group using a random number table with 32 patients in each group. The ob- servation group was treated with laparoscopic D2 gastrectomy, and the control group was treated with con- ventional open distal gastrectomy. Operation associated indexes, recovery of body function at 1 month after the operation, complications and 1-year survival rate were compared between the two groups. Results The incision length and surgery duration was less in the observation group than in the control group （ all P 〈 0. 05 ）. Time of anal exhaust, time out of bed, time to eat, time of hospitalization and the volume of postop- erative gastric bleeding were less in the observation group than in the control group （ all P 〈 0. 05 ）. The in- cidence of complication was 12. 5% for the observation group, which was lower than 37.5% of the control group （P 〈 0. 05 ）. There was no significant difference in 1-year survival period between the two groups （ P 〉 0. 05 ）. Conclusion Laparoscopic D2 gastrectomy shows significant efficacy in the treatment of ad- vanced gastric cancer. It can reduce surgical duration and postoperative gastric bleeding, promote recovery of body function and reduce disease mortality with high safety.