腹腔镜胃癌根治术与开放性胃癌根治术的对比研究

Comparative study of laparoscopic radical gastrectomy and open radical gastrectomy for gastric cancer

目的探讨腹腔镜胃癌根治术与开放性胃癌根治术的临床疗效差异,对腹腔镜手术可行性进行评价。方法选取2016年1月至2018年1月本院收治的60例腹腔镜下胃癌根治术切除患者,与同期行开放性胃癌根治术治疗的58例患者进行对比分析,观察手术疗效。结果 60例患者在腹腔镜辅助下完成手术,其中清扫D1淋巴结4例,D2淋巴结56例。腹腔镜手术患者的术后住院时间、肛门排气时间均短于开放组(P<0.05);腹腔镜组的吻合口瘘及肺部感染并发症少于开放组(P<0.05);腹腔镜组术中平均出血量、引流量均少于开放组(P<0.05);腹腔镜组平均手术时间长于对照组(P<0.05);淋巴结清扫平均数比较差异无统计学意义;死亡率比较差异无统计学意义。结论腹腔镜下行胃癌根治术更加安全、可靠,淋巴清扫率与开放根治术具有相同效果。

Objective To investigate the effect of laparoscopic radical gastrectomy and open gastrectomy for gastric cancer clinical curative effect, to evaluate the feasibility of laparoscopic surgery. Methods January 2016-2018 year in January in our hospital 60 cases of laparoscopic radical resection of gastric cancer patients, compared with the same period in 58 cases underwent open surgery treatment of gastric cancer patients, observation the efficacy of surgery. Results 60 patients in the laparoscopic surgery completed, including cleaning D1 lymph nodes in 4 cases, D2 lymph nodes in 56 cases. The hospitalization time of patients undergoing laparoscopic surgery after operation, anal exhaust time were shorter than the open group （P〈0.05）;The complications of anastomotic fistula and pulmonary infection in the laparoscopic group were less than those in the open group （P〈0.05）. The mean operative time in the laparoscopic group was longer than that in the control group （P〈0.05）, there was no significant difference in the mean number of lymph node dissection, and there was no significant difference in mortality.Conclusion Laparoscopic radical gastrectomy is more safe and reliable, and the rate of lymphatic dissection is the same as that of open radical gastrectomy.