腹腔镜D2根治术治疗胃癌的临床效果及预后观察

Clinical effect and prognosis of laparoscopic radical mastectomy for gastric

目的探讨腹腔镜D2胃癌根治术对胃癌患者的手术效果、安全性及远期预后的影响。方法选取2011年1月至2013年12月接受胃癌根治性手术治疗的190例患者进行回顾性分析,根据手术方式分为腹腔镜组98例、传统开腹手术92例(开腹组),数据分析采用SPSS16.0进行处理,手术相关指标比较采用均数±标准差统计描述,采用独立t检验;并发症率、3年生存率比较采用χ2检验;生存时间分析采用Kaplan-meier法;P值<0.05表示差异具有统计学意义。结果腹腔镜组患者的手术时间长于开腹组(P<0.05);腹腔镜组患者的手术出血量、切口长度、肛门排气时间、术后镇痛药使用率、胃肠减压时间、住院时间均低于开腹组(P<0.05),两组患者的清扫淋巴结数目、阳性淋巴结数目差异无统计学意义(P>0.05);腹腔镜组患者的手术并发症12.2%低于开腹组的25.0%(χ2=5.137,P=0.023<0.05);腹腔镜组患者的3年生存率52.5%低于开腹组的60.5%;腹腔镜组患者的中位平均时间31.2个月低于开腹组的32.6个月,但差异均无统计学意义(P>0.05)。结论腹腔镜D2胃癌根治术相对于传统开腹手术具有创伤程度低、术后恢复快、并发症少的优势,同时手术效果基本相当。

Objective To explore the effect of laparoscopic radical gastrectomy for gastric cancer in patients with gastric cancer,the safety and long-term prognosis. Methods Selected 190 patients who underwent radical gastrectomy for gastric cancer between January 2011 and December 2013 were retrospectively analyzed,according to the operation mode,98 cases were divided into laparoscopic group and 92 cases by laparotomy(laparotomy group),data analysis was carried out by SPSS16.0,and operation related indexes were compared by mean±standard deviation statistical description,and t test was used;The complication rate and the 3 year survival rate were compared byχ2 test,and the survival time was analyzed by Kaplan-meier method.The P<0.05 indicated that the difference was statistically significant.Results The operation time of laparoscopic group of patients than the laparotomy group(P<0.05);the laparoscopic group of patients with surgical incision length,bleeding volume,anal exhaust time,postoperative analgesic use,hospitalization time,gastrointestinal decompression time were lower than the traditional group(P<0.05),there was no significant difference in the number of lymph nodes and the number of positive lymph nodes between the two groups(P> 0.05);The operative complication in laparoscopic group was 12.2%lower than that in open group 25.0%(χ2=5.137,P=0.023<0.05).The median 3-year survival rate was 52.5%in the laparoscopic group and 60.5%in the laparotomy group;The mean median time of laparoscopic group was 31.2 months lower than that of the laparotomy group 32.6 months,the difference was not statistically significant(P>0.05). Conclusion Laparoscopic radical gastrectomy of gastric cancer compared with the traditional open surgery has a low degree of trauma,postoperative recovery quickly,less complications,while the surgical effect is basically the same.