腹腔镜辅助胃癌根治术治疗进展期胃癌临床指标评价及随访观察

Evaluation of clinical evaluation and follow-up observation of laparoscopy-assisted radical gastrectomy in the treatment of advanced gastric cancer

目的探讨腹腔镜辅助胃癌根治术与开腹胃癌根治术治疗进展期胃癌患者的临床疗效,并随访观察并发症发生情况。方法选取我科2015年1月~2016年12月收治的142例进展期胃癌患者为本次研究对象,根据患者意愿采取不同手术方式进行治疗,再根据不同手术方式将其分为对照组和观察组,对照组70例行开腹胃癌根治术,观察组72例行腹腔镜辅助胃癌根治术,观察两组患者的临床指标并随访并发症发生情况。结果两组患者的术中临床指标除吻合方式及清扫淋巴结数目外,差异均有统计学意义(P<0.05);术后临床指标除CRP术前1 d无差异外,其余指标差异均有统计学意义(P<0.05);两组患者并发症发生率比较,差异无统计学意义(P>0.05);对照组患者1例出现吻合口复发,1例出现肝转移;观察组患者1例出现后腹膜转移。两组患者均无死亡病例及远期肠梗阻发生。结论腹腔镜辅助胃癌根治术治疗进展期胃癌患者具有安全及微创优势,疗效较开腹胃癌根治术更好。

Objective To evaluate the clinical efficacy of laparoscopy-assisted radical gastrectomy and open radical gastrectomy in the treatment of advanced gastric cancer, and to observe the occurrence of complications in follow-up visits. Methods A total of 142 patients with advanced gastric cancer who were admitted to our department from January 2015 to December 2016 were selected as the study subjects. According to different willingness of the patients, different surgical methods were adopted. The patients were divided into control group and observation group according to differ- ent surgical methods. 70 patients in the control group were given open radical gastrectomy, and 72 patients in the ob- servation group were given laparoscopy-assisted radical gastrectomy. The clinical indicators of the two groups were ob- served and the incidence of complications was followed up. Results The differences of intraoperative clinical indices in the two groups were statistically significant apart from the anastomotic methods and the number of cleaned lymph nodes （P〈0.05）. There were statistically significant differences in the postoperative clinical indices apart from CRP 1 d before the surgery（P〈0.05）; there was no statistically significant difference in the incidence of complications between the two groups （P〉0.05）; in the control group, one patient had anastomotic recurrence and one patient had liver metastasis; one patient in the observation group had posterior peritoneal metastasis. There were no deaths and long-term intestinal ob- struction in both groups. Conclusion Laparoscopy-assisted radical gastrectomy for patients with advanced gastric can- cer is safe and minimally invasive. The curative effect is better than open radical gastrectomy.