两种根治性D2全胃切除术的应用效果比较

The Effects Comparison of Two Kinds of D2 Gastrectomy Surgeries

目的比较腹腔镜下辅助D2全胃切除术与传统开腹D2全胃切除术的手术效果。方法回顾性分析我院收治的180例胃癌患者的临床资料,所有患者均采用根治性D2全胃切除术,其中,观察组90例患者采取腹腔镜下辅助D2全胃切除术,对照组90例患者采取传统开腹D2全胃切除术,比较两组患者的手术效果。结果观察组患者的手术时间、术中出血量、术后排气时间、术后住院时间分别为(254.3±26.5)min、(139.2±34.6)ml、(3.3±0.8)d及(10.3±1.5)d,等均明显优于对照组患者(207.3±24.6)min、(266.5±58.7)ml、(5.7±1.2)d及(13.5±1.8)d,组间差异具有统计学意义(P<0.05),手术后1个月,腹腔镜组患者的CRP较传统开腹组患者出现了明显改善,组间差异具有统计学意义(P<0.05);两组患者的肿瘤标志物CEA、CA199、CA125水平均显著下降,且组间差异无统计学意义,观察组患者并发症发生率为15.5%(14/90),明显低于对照组患者(28.9%),组间差异具有统计学意义(P<0.05)。结论采用腹腔镜辅助根治性D2全胃切除术与传统开腹术具有基本一致的效果,而腹腔镜由于其微创特点,对机体的损伤也明显较低,对患者的创伤较小,有利于患者术后早期恢复,促进患者预后,值得临床应用。

Objective To compare the efficacy of traditional open surgical D2 gastrectomy and gastrectomy D2 laparoscopic.Methods 180 cases of gastric cancer patients were included in the study, in which 90 patients in the observation group took laparoscopy By assist D2 total gastrectomy, 90 patients in the control group are taking traditional open D2 total gastrectomy, surgical results between the two groups of patients. Results The patient’s operation time blood loss,postoperative exhaust time, postoperative hospital stay were(254.3±26.5)min,(139.2±34.6)ml,(3.3±0.8)d,(10.3±1.5)d and significantly better than the control group of patients(207.3±24.6)min,(266.5±58.7)ml,(5.7±1.2)d、(13.5±1.8)d, the difference was statistically significant(P<0.05) between the two groups, one month after surgery,abdominal mirror group of patients with CRP compared with traditional open a significant improvement in patients, the difference was statistically significant(P<0.05) between the two groups;tumor markers CEA two groups of patients, were significantly decreased CA199, CA125 water, and between-group differences no significant complication rate was observed in patients 15.5%(14/90), significantly lower than the control group of patients(28.9%),the difference was statistically significant(P<0.05) between the two groups. Conclusion Laparoscopic assisted radical total gastrectomy with D2 traditional open surgery has basically the same effect, but because of its minimally invasive laparoscopic characteristics, damage to the body is also significantly lower, less trauma to the patient, there is help patients early postoperative recovery, promote prognosis, worth clinical application.