腹腔镜手术治疗进展期胃癌的临床研究

Clinical study of laparoscopic surgery in the treatment of advanced gastric cancer

目的探讨腹腔镜手术治疗进展期胃癌的临床效果。方法选取行胃癌根治术的64例进展期胃癌患者,随机分为对照组(32例)和观察组(32例)。对照组择期行开放性胃癌手术,观察组择期行腹腔镜辅助胃癌根治术,对比两组患者的手术相关指标、术后并发症发生率及术后1年复发率。结果观察组手术时间显著长于对照组,手术切口长度和住院时间短于对照组,术中出血量少于对照组,术后早期VAS评分低于对照组,术后肛门排气时间显著早于对照组(均P<0.05)。两组淋巴结清扫数目差异无统计学意义(P>0.05)。观察组术后并发症发生率(6.25%)显著低于对照组(28.12%)(P<0.05)。观察组术后1年复发率与对照组比较,差异无统计学意义(9.38%vs.6.25%,P>0.05)。结论与开放性术式相比,腹腔镜手术治疗进展期胃癌疗效肯定,创伤性较小,安全性较高,值得推广应用。

Objective To investigate the clinical effect of laparoscopic surgery in the treatment of advanced gastric cancer.Methods A total of 64 patients with advanced gastric cancer underwent radical gastrectomy were selected and randomly divided into control group(32 cases)and observation group(32 cases).The control group underwent elective open gastric cancer surgery,and the observation group underwent elective laparoscopy-assisted radical gastrectomy.The operation related indexes,the incidence of postoperative complications and the recurrence rate one year after operation were compared between the two groups.Results Compared with the control group,the observation group yielded significantly longer operation time,shorter length of surgical incision and hospital stays,less amount of intraoperative blood loss,a lower early postoperative VAS score,and earlier postoperative anal exhaust time(all P<0.05).There was no statistically significant difference in the number of lymph nodes dissection between the two groups(P>0.05).The incidence of postoperative complications in the observation group was significantly lower than that in the control group(6.25%vs.28.12%,P<0.05).There was no statistically significant difference in the recurrence rate one year after operation between the two groups(9.38%vs.6.25%,P>0.05).Conclusion Compared with the open surgery,laparoscopic surgery has a certain efficacy,less trauma and higher safety in treating advanced gastric cancer,which is worthy of promotion and application.