腹腔镜辅助胃癌根治术在老年胃癌患者中的应用分析

Application analysis of laparoscopic-assisted radical gastrectomy for gastric cancer in the elderly

目的:探讨老年胃癌患者行腹腔镜辅助胃癌根治术的安全性及临床疗效。方法:2013年1月至2016年6月为104例老年(>65岁)胃癌患者行胃癌D2根治术,其中56例行腹腔镜辅助胃癌根治术(腔镜组),48例行开腹胃癌根治术(开腹组)。比较两组术前合并症、术中情况及术后恢复情况,并对并发症的危险因素进行分析。结果:腔镜组术中出血量、术后首次排气时间、拔除引流管时间、拔胃管时间及术后住院时间均优于开腹组,差异有统计学意义(P<0.05)。手术时间及术前合并症是术后并发症的独立危险因素。结论:老年人行腹腔镜辅助胃癌根治术能取得与开腹手术相同的根治效果,且具有明显的微创优势。

Objective： To explore the safety and efficacy of laparoscopic-assisted radical gastrectomy for elderly patients with gastric cancer. Methods： From Jan. 2013 to Jun. 2016,104 elderly patients（ 65 years old） with gastric cancer underwent D2 radical gastrectomy. Among them,56 patients underwent laparoscopic-assisted radical gastrectomy（ laparoscopic group） and 48 patients underwent open radical gastrectomy（ laparotomy group）. The preoperative comorbidity,intraoperative condition and postoperative recovery were compared between the two groups,and the risk factors of complications were analyzed. Results： The bleeding volume,the time of first exhaust,the time of drainage,the time of gastric tube removal and the hospital stay after operation in the laparoscopic group were all less than those in the laparotomy group,the differences were statistically significant（ P 0. 05）. Operative time and preoperative comorbidity were independent risk factors for postoperative complications. Conclusions： Laparoscopic-assisted radical gastrectomy for gastric cancer in the elderly can achieve the same radical effect as open surgery and has obviously minimally invasive advantages.