全胃切除术对胃癌患者的远期疗效及术后并发症的影响

Effect of long-term efficacy and postoperative complications of total gastrectomy in patients with gastric cancer

目的探讨腹腔镜全胃部切除术和开腹全胃切除术胃癌患者的远期疗效和术后并发症发生情况。方法回顾性分析我院2010年2月至2012年1月收治的78例胃癌患者患者的临资料,根据手术方式不同,将78例患者分成腹腔镜组(n=40,行腹腔镜下全胃切除术)和开腹组(n=38,开腹全胃切除术)。比较两组患者的术中、术后相关指标、术后并发症发生情况和远期疗效。结果腹腔镜组患者手术时间长于开腹组,但术中出血量、术后住院时间、术后肛门排气时间均优于开腹组(P<0.05),两组患者的淋巴结清扫数目、术后并发症总发生率比较,差异无统计学意义(P>0.05);两组患者术后1、3、5年的生存率比较,差异无统计学意义(P>0.05)。结论与开腹全胃切除术相比,腹腔镜全胃切除术治疗胃癌的远期临床疗效和并发症发生情况相当,但腹腔镜手术对机体的创伤更小。

Objective To explore the effect of long-term efficacy and postoperative complications of total gastrectomy in patients with gastric cancer. Methods A total of 78 patients with gastric cancer from Febrary 2010 to January 2012 were selected as study subjects, they were divided into laparoscopy group （n=40, treated with laparoscopic total gastrectomy） and laparotomy group （n=38 treated with open total gastrectomy）. The intraoperative and postoperative related indicators, postoperative complications and long-term efficiency of the patients in both groups were compared. Results The operation time in the laparoscopy group was longer than that of the laparotomy group, but the intraoperative blood loss, postoperative hospital stay, postoperative anal exhaust time of the laparoscopy group were superior to the laparotomy group （P〈0.05）, while there were no significant differences in the number of lymph node dissection and postoperative total incidences of complications between the two groups （P〉0.05）; there was no significant difference in survival rates between the two groups within postoperative 1, 3 and 5 years （P〉0.05）. Conclusion Compared with the open total gastrectomy, there has an equal long-term efficiency and postoperative complications of the laparoscopy total gastrectomy, btu there are less trauma in patients.