开腹与腹腔镜辅助下远端胃癌D2根治术治疗进展期胃癌的疗效及对循环肿瘤细胞的影响

Efficacy of open or laparoscopic distal gastrectomy with D2 lymphadenectomy in treating advanced gastric cancer and its effect on circulating tumor cells

目的探讨开腹与腹腔镜辅助下远端胃癌D2根治术治疗进展期胃癌的疗效及对循环肿瘤细胞(CTC)的影响。方法采用随机数字表法将88例进展期胃癌患者分为对照组和观察组,每组44例。对照组患者接受开腹远端胃癌D2根治术治疗,观察组患者接受腹腔镜辅助下远端胃癌D2根治术治疗。比较两组患者的手术相关指标、术后不良反应发生情况及术后CTC水平。结果观察组患者的手术时间、术后肛门排气时间、术后下床活动时间、术后进食流质饮食时间、术后平均住院时间均短于对照组,手术切口长度小于对照组,术中出血量少于对照组,不良反应发生率及术后CTC水平均低于对照组,差异均有统计学意义(P﹤0.05)。结论与开腹手术比较,腹腔镜辅助下远端胃癌D2根治术治疗进展期胃癌的疗效更佳,并且可以有效降低患者的CTC水平。

Objective To investigate the short-term effect of open or laparoscopic distal gastrectomy with D2 lymphadenectomy in the treatment of advanced gastric cancer and the impact on circulating tumor cells(CTC).Method A total of 88 patients with gastric cancer were included in the study and divided into control group and study group according to a random number table,with 44 cases in each.The control group was treated with open distal gastrectomy D2 lymphadenectomy,while the study group was administered with laparoscopic distal gastrectomy with D2 lymphadenectomy.The surgery-related indicators,occurrence of postoperative adverse reactions and the level of CTC detection after operation were compared between the two groups.Result The operative time,postoperative time to anal exhaust,postoperative time to ambulation,time to liquid diet after operation and average hospitalization time were less,and the length of surgical incision was shorter,besides,the intraoperative blood loss was less in study group than in control group,additionally,study group patients had significantly lower incidence of adverse reactions and postoperative CTC level compared to control group(P<0.05).Conclusion Compared with open surgery,laparoscopic distal gastrectomy with D2 lymphadenectomy demonstrates significantly better short-term effect when applied in the treatment of on advanced gastric cancer,and the therapy can effectively reduce the level of CTC among these patients.