腹腔镜辅助下进展期远端胃癌根治术的可行性及近期疗效

The feasibility and short-term effect of laparoscopic assisted radical surgery for advanced distal gastric cancer

目的探讨腹腔镜辅助下进展期远端胃癌根治术的可行性及近期疗效。方法依据随机数字表法,从2015年9月至2016年9月开封市中心医院收治的进展期远端胃癌患者中抽取40例为对照组,均接受常规开腹远端胃癌根治术。依据随机数字表法,从2016年10月至2017年10月开封市中心医院收治的进展期远端胃癌患者中抽取40例为观察组,均接受腹腔镜辅助下进展期远端胃癌根治术。观察并比较两组患者的术中指标、术后恢复情况及术后并发症发生率。结果观察组患者的手术时间明显长于对照组,淋巴结清扫个数明显多于对照组,术中出血量明显少于对照组,差异均有统计学意义(P﹤0.01)。观察组患者术后首次下床活动时间、术后排气时间和住院时间均明显短于对照组(P﹤0.01)。观察组患者术后并发症总发生率为7.5%,低于对照组的25.0%,差异有统计学意义(P﹤0.05)。结论对进展期远端胃癌患者实施腹腔镜辅助下胃癌根治术的近期疗效确切,且可有效减少各种术后并发症,具有一定的临床应用可行性。

Objective To explore the clinical feasibility and short-term effect of laparoscopic assisted radical surgery for advanced distal gastric cancer. Method According to random data sheet, 40 patients with advanced distal gastric cancer diagnosed in our hospital from September 2015 to September 2016 were randomly selected as control group and underwent conventional open radical resection for advanced distal gastric cancer; 40 patients with advanced distal gastric cancer diagnosed in our hospital from October 2016 to October 2017 were randomly selected as observation group and underwent laparoscopic assisted radical surgery. The intra-and post-operative indexes and the incidence of complications were observed and compared between the two groups. Result The operation time was significantly longer, the number of lymph node dissection was significantly more and the blood lose volume was significantly lower in the observation group than those in the control group（P〈0.01）. The time of first off-bed, postoperative exhaust and hospitalization in the observation group were significantly shorter than those in the control group（P〈0.01）. The incidence of complications in the control group（25.0%） was significantly higher than that in the observation group（7.5%）（P〈0.05）. Conclusion Laparoscopic assisted radical surgery for advanced distal gastric cancer is efficacy and can effectively reduce postoperative complications, which is feasible for clinical application.