腹腔镜胃癌根治术治疗进展期胃癌的疗效分析

Analysis on the efficacy of laparoscopic radical gastrectomy in the treatment of advanced gastric cancer

目的探讨腹腔镜胃癌根治术治疗进展期胃癌的疗效,旨在为腹腔镜辅助胃癌根治术的临床推广及应用提供有利的参考依据。方法选择2016年1月~2017年1月我院行腹腔镜胃癌根治术患者40例作为观察组,另外选择同期行开腹手术患者40例作为对照组,对比两组的手术效果。结果观察组患者的手术时间为(140.5±18.2)min,明显短于对照组,观察组的术中出血量为(132.4±22.6)m L,明显少于对照组,观察组的术后下床活动时间为(2.3±0.7)d,明显短于对照组,两组比较差异有统计学意义(P<0.05)。观察组患者无一例出现肺部感染、腹腔感染、肠梗阻,对照组患者出现肺部感染2例、腹腔感染1例、吻合口出血2例、吻合口瘘4例、肠梗阻3例,两组并发症发生率分别为5.0%、30.00%,观察组患者的并发症发生率明显低于对照组,两组比较差异有统计学意义(P<0.05)。结论腹腔镜胃癌根治术治疗进展期胃癌手术效果确切,较开腹手术具有较多优点,如术中出血少、术后并发症少及术后恢复快等,值得临床广泛推广和应用。

Objective To investigate the curative effect of laparoscopic radical gastrectomy in the treatment of advanced gastric cancer, so as to provide a favorable reference for the clinical application and promotion of laparoscopic radical gastrectomy. Methods From January 2016 to January 2017, 40 patients undergoing laparoscopic radical gastrectomy in our hospital were selected as the observation group. Another 40 patients undergoing laparotomy during the same period were selected as the control group. The surgical results were compared between the two groups. Results The surgery time in the observation group was（140.5±18.2）min, which was significantly shorter than that in the control group. The intraoperative blood loss was（132.4±22.6）m L in the observation group, which was significantly less than that in the control group. The postoperative off-bed activity time was（2.3±0.7）d in the observation group, which was significantly shorter than that in the control group. There was significant difference between the two groups（ P〈0.05）. There was no case in the observation group who had pulmonary infection, abdominal infection and intestinal obstruction. In the control group, there were 2 cases of pulmonary infection, 1 case of abdominal infection, 2 cases of anastomotic bleeding, 4 cases of anastomotic fistula, and 3 cases of intestinal obstruction. The incidence rate of complications in the two groups were 5.0% and 30.00% respectively. The incidence rate of complications in the observation group was significantly lower than that in the control group. There was significant difference between the two groups（P〈0.05）. Conclusion Laparoscopic radical gastrectomy in the treatment of advanced gastric cancer surgery is effective, which has more advantages than open surgery, such as less bleeding, fewer postoperative complications and rapid recovery, which is worthy of wide clinical promotion and application.