开腹与腹腔镜辅助手术治疗胃癌肝转移的疗效对比分析

Comparative analysis of clinical efficacy of laparotomy and laparoscopic-assisted surgery for liver metastasis from gastric cancer

目的对比开腹与腹腔镜辅助手术治疗胃癌肝转移(GCLM)的临床疗效与术后生存情况。方法回顾性分析2016年6月至2017年6月宜宾市第一人民医院收治的150例GCLM患者临床资料,根据手术类型将其分为开腹组(78例)和腹腔镜组(72例)。对比两组患者的临床资料、围手术期相关指标、术后并发症发生情况,Kaplan-Meier法分析患者术后2年生存情况。结果与开腹组相比,腹腔镜组患者的手术时间更长,术中出血量更少,术后通气时间、住院时间显著缩短(P<0.05),但两组术后并发症总发生率比较,差异无统计学意义。中位随访时间30(24~36)个月,两组平均生存时间以及术后2年生存率比较,差异均无统计学意义(t=1.257,P=0.211;χ^2=0.530,P=0.511)。结论与开腹手术相比,腹腔镜辅助治疗GCLM出血量少,术后恢复时间短,周围淋巴结清扫效果、预后生存情况相似,安全可行。

Objective To compare the clinical efficacy of laparotomy and laparoscopic-assisted surgery in the treatment of gastric cancer with liver metastasis(GCLM)and to analyze the postoperative survival.Methods The clinical data of one hundred and fifty patients with GCLM admitted to Yibin First People’s Hospital from June 2016 to June 2017 were retrospectively analyzed.They were divided into laparotomy group(78 cases)and laparoscopic group(72 cases).The clinical data,perioperative indicators,postoperative complications,and 2-year survival were compared between the two groups.Results Compared with the laparotomy group,the laparoscopic group had longer operation time,less intraoperative bleeding,shorter postoperative ventilation time and hospitalization time(P<0.05),but there was no significant difference in the total incidence of complications between the two groups.After 30(24-36)months of median follow-up,there were no significant differences in mean survival time and 2-year survival rate after surgery between the two groups(t=1.257,P=0.211;χ^2=0.530,P=0.511).Conclusion Compared with laparotomy,laparoscopic assisted treatment of GCLM has less bleeding,shorter recovery time,similar effect of peripheral lymph node dissection,prognosis and survival,and is safe and feasible.