腹腔镜辅助和开腹D2根治术治疗进展期远端胃癌的临床分析

Clinical Analysis of Laparoscopic Assisted and Open D2 Radical in the Treatment of Progressive Distal Gastric Cancer

目的比较腹腔镜辅助和开腹D2根治术治疗进展期远端胃癌的临床价值。方法回顾性分析80例进展期远端胃癌患者的临床资料,其中接受腹腔镜手术44例(A组)、开腹D2根治术36例(B组)。比较2组术中、术后情况,淋巴结清扫情况,术后短期并发症及近期预后情况。结果 A组切口长度、术中失血量、术后排气时间、术后进流食时间、术后住院时间均显著少(小)于B组(P<0.05);2组淋巴结清扫数目无统计学差异(P>0.05);2组术后短期并发症无统计学差异(P>0.05)。2组随访平均(17.3±5.3)个月,除A组1例ⅢB期术后14个月因肝转移死亡外,其余均未见复发或远处转移。结论腹腔镜手术治疗进展期远端胃癌的根治性效果与开腹D2根治术相近,但具有微创的优势,临床应用价值高。

Objective To compare the clinical value of laparoscopic assisted and open D2 radical in the treatment of progressive distal gastric cancer. Methods The clinical data of 80 patients with progressive distal gastric cancer were analyzed retrospectively,including conducted by laparoscopic D2 radical with 44 cases（ group A） and open D2 radical with 36 cases（ group B）. The intraoperative and postoperative situation,lymph node dissection,postoperative short-term complications and short-term prognosis were compared between the two groups. Results Incision length,blood loss and postoperative exhaust time,postoperative advanced liquid time,postoperative hospitalization time in the group A were significantly less（ smaller） than the group B（ P〈 0. 05）. There were no significant difference between the 2 groups in the number of lymph node（ P 〉 0. 05）. There were no significant difference between the 2 groups in the postoperative short-term complications node（ P 〉 0. 05）. The 2 groups were followed up for an average of（ 17. 3 ± 5. 3） months,except for 1 patient with ⅢB phase in the group A died of liver metastasis 14 months after the operation,the rest of the patients had no recurrence or distant metastasis. Conclusion Laparoscopic surgery for advanced distal gastric cancer is similar with open D2 radical resection,and it has the advantages of minimally invasive,which has a high clinical value.