不同临床特征患者腹腔镜与开腹胃癌根治术的淋巴结清扫效果及其术后复发转移的对比研究

A comparative study on the effect of lymphadenectomy and postoperative recurrence and metastasis between laparoscopic and open radical gastrectomy in patients with different clinical characteristics

目的:对比不同临床特征患者腹腔镜与开腹胃癌根治术的淋巴结清扫效果及其术后的复发转移情况。方法:选取我院2013年1月至2017年1月收治的173例胃癌患者,其中88例腹腔镜胃癌根治术患者设为观察组,85例开腹胃癌根治术患者设为对照组。比较2组患者的手术情况和不同临床特征2组患者淋巴结清扫情况;比较2组患者术后随访24个月肿瘤复发转移情况。结果:观察组的手术时间显著长于对照组,术中出血量、术口长度、住院天数显著短于对照组(P<0.01);观察组患者平均淋巴结清扫数目(25.79±5.53)枚,与对照组的(26.39±5.97)枚比较,差异无统计学意义(P>0.05)。按肿瘤特征分层比较,2组患者的淋巴结清扫效果差异无统计学意义(P>0.05);2组患者随访12、24个月的肿瘤复发转移率比较,差异无统计学意义(P>0.05)。结论:在相似的临床特征条件下,腹腔镜胃癌根治术的淋巴结清扫效果、肿瘤转移复发率均与开腹手术相当,但腹腔镜手术可显著减少患者的手术创伤,有利于患者的术后康复。

Objective:To compare the effect of lymphadenectomy and the postoperative recurrence and metastasis between laparoscopic and open radical gastrectomy in patients with different clinical characteristics.Methods:A total of 173 patients with gastric cancer were selected from Jan 2013 to Jan 2017,88 patients were in the laparoscopic gastrectomy group(group A),and 85 patients were in the open radical gastrectomy group(group B).The operation conditions of the two groups were compared.The lymphadenectomy of the two groups with different clinical characteristics were compared.After 12 and 24 months of follow-up,the recurrence and metastasis of the two groups were compared.Results:The operation time of group A was significantly longer than that of group B,the amount of intraoperative bleeding was significantly less and the length of operative incision and the hospitalization days were significantly shorter than those of group B(P<0.01).The average number of lymph node dissection in group A was(25.79±5.53)and that in group B was(26.39±5.97),the difference was not statistically significant(P>0.05).There was no significant difference in the effect of lymph node dissection between the two groups with different clinical characteristics(P>0.05).There was no significant difference in the recurrence and metastasis rates at 12 and 24 months of follow-up(P>0.05).Conclusion:Under similar clinical characteristics,laparoscopic radical gastrectomy has the same effect of lymph node dissection and metastasis and recurrence rate as open surgery,but laparoscopic surgery can significantly reduce the surgical trauma of patients,which is conducive to the postoperative recovery of patients.