70岁以上老年胃癌患者行腹腔镜辅助胃癌根治术的安全性和可行性

Safety and feasibility of laparoscopic assisted radical gastrectomy for elderly patients over 70 years old with gastric cancer

目的探讨70岁以上老年胃癌患者行腹腔镜辅助胃癌根治术的安全性和可行性。方法回顾性分析2013年3月至2015年3月收治的56例老年胃癌患者临床资料,依据手术方法不同将其分成腹腔镜组与开腹组,各28例。开腹组使用传统开腹手术治疗,腹腔镜组使用腹腔镜辅助胃癌根治术,数据采用SPSS18.0统计处理,两组患者术中指标、术后恢复情况等计量资料采用(x珋±s)表示,行独立t检验;两组患者并发症发生率等计数资料使用%表示,行卡方检验,当P<0.05时差异有统计学意义。结果腹腔镜组患者术中失血量、术后排气时间及术后住院时间情况显著少于开腹组,P<0.05;两组患者手术时间、淋巴结清扫数目、上下切缘距离差异无统计学意义,P>0.05;腹腔镜组患者术后有6例出现并发症(21.4%),开腹组有10例(35.7%),两组差异无统计学意义,P>0.05;但是腹腔镜组患者切口感染率为3.6%(1/28)显著低于开腹组14.3%(4/28),P<0.05;结论 70岁以上老年胃癌患者行腹腔镜辅助胃癌根治术治疗效果较好,降低了切口感染率,安全可行,值得使用与推广。

Objective To explore the safety and feasibility of laparoscopic radical gastrectomy for gastric cancer patients over 70 years old. Methods Clinical data of 56 elderly patients with gastric cancer admitted from March 2013 to March 2015 were retrospectively analyzed,56 patients were divided into laparoscopic group(28 cases)and Laparotomy group(28 cases)respectively.Traditional open surgery were performed in Laparotomy group,while laparoscope were applied in Laparoscopic group.Statistical analysis were performed by using SPSS18.0 software.Intraoperative and postoperative clinical indicators were presented as mean±standard deviation,and were examined by using t test.The postoperative complication rate were expressed as%,and were compared withχ2 test.P<0.05 was thought to be statistically significant. Results Compared with Laparotomy group,there were less intraoperative blood loss,earlier postoperative exhaust time and shorter postoperative hospitalization time in laparoscopic group,with significant difference(P<0.05).There was no statistically significant difference between 2 groups in terms of operation time,number of harvested lymph nodes,distal and proximal dissection margin distance(P>0.05).There were 6 cases of complications(21.4%)in laparoscopic surgery,and 10 cases(35.7%)in laparotomy group,with no significant difference(P>0.05).However,the incision infection rate in the laparoscopic group was 3.6%(1/28),which was significantly lower than 14.3%(4/28)in laparotomy group(P<0.05). Conclusion Clinical outcome of laparoscopic gastrectomy for elderly patients with gastric cancer is satisfactory,with decreasing infection rate.which is safe and feasible,and worthy of clinical promotion.