腹腔镜辅助胃癌根治术的近期疗效分析

Analysis of short-term efficacy of laparoscopic gastrectomy for gastric cancer and Summary of Operative Experience

目的比较腹腔镜辅助与传统开腹胃癌根治术的近期疗效,并结合文献总结腹腔镜辅助胃癌根治术的术中要点。方法收集2018年1月—2020年1月笔者所在医院收治的70例胃癌患者的临床资料,并根据手术方式分为腹腔镜(LG)组与开腹(OG)组,腹腔镜组行腹腔镜辅助胃癌根治术,开腹组行传统开放式胃癌根治术,比较两组患者的术中及术后情况。结果LG组45例,OG组25例,两组患者在性别、年龄、ASA分级、腹部手术史、肿瘤分期、术式、BMI等基线数据方面差异无统计学意义(P>0.05)。术中情况方面,两组在淋巴结清扫数方面差异无统计学意义(P=0.815),LG组的手术持续时间长于OG组(P=0.021),但术中失血量低于开腹组(P<0.010);术后情况方面,两组在术后并发症(P=0.637)、围手术期死亡(P=1.000)方面差异无统计学意义。而LG组的术后进食时间(P=0.026)、住院时间(P<0.010)均显著短于OG组。结论腹腔镜辅助胃癌根治术是一种安全有效的手术方式,具有术中失血量少、术后恢复饮食早、住院时间短等优势。

Objective To evaluate the safety and efficacy of laparoscope-assisted radical gastrectomy in non-large medical centers,and to summarize the main points of laparoscope-assisted radical gastrectomy.Methods The clinical data of patients undergoing radical gastrectomy in our hospital from January 2018 to January 2020 were retrospectively analyzed,and the clinical data of patients undergoing laparoscopic and traditional radical gastrectomy in the same period were retrospectively compared.Results There were 45 cases in LG group and 25 cases in OG group.There was no statistically significant difference between the two groups in the baseline data such as gender,age,ASA grade,abdominal surgery history,tumor stage,surgical method and BMI(P>0.05).There was no significant difference in the number of lymph node dissection between the two groups(P=0.815).The operative duration of LG group was longer than OG group(P=0.021),but the intraoperative blood loss was lower than that of the open group(P<0.010).In terms of postoperative conditions,there was no statistical difference between the two groups in postoperative complications(P=0.637),perioperative death(P=1.00).The postoperative oral intake time(P=0.026)and hospital stay(P<0.010)of LG group were significantly shorter than those of OG group.Conclusion Laparoscopic assisted radical gastrectomy is a safe and effective surgical method,which has the advantages of early postoperative oral food intake,less intraoperative blood loss and hospital stay.