微创远端胃癌手术结合D2淋巴结清扫治疗胃癌的临床效果

Clinical effect of minimally invasive distal gastric cancer surgery combined with D_(2) lymph node dissection in the treatment of gastric cancer

目的探究微创远端胃癌手术结合D_(2)淋巴结清扫治疗胃癌的临床效果。方法选取2018年3月至2020年9月我院收治的76例胃癌患者作为研究对象,按照随机数字表法将其分为对照组(传统开腹手术+D_(2)淋巴结清扫治疗)与观察组(微创远端胃癌手术+D_(2)淋巴结清扫治疗),各38例。比较两组的手术相关指标、肿瘤根治效果、血清肿瘤标志物指标、术后并发症发生情况。结果观察组的手术时间、术后排气时间、下床活动时间、住院时间、进食流质食物及半流质食物时间均短于对照组,术中出血量少于对照组(P<0.05)。观察组的近端及远端切缘长度、淋巴结数目与对照组比较,差异无统计学意义(P>0.05)。术后1周,两组的血清PGⅠ水平均高于术前,CA724水平均低于术前,且观察组优于对照组(P<0.05)。观察组的并发症总发生率为5.26%,低于对照组的23.68%(P<0.05)。结论微创远端胃癌手术结合D_(2)淋巴结清扫应用于胃癌治疗中具有创伤小、术后恢复快的优势,能够达到与开腹手术相近的效果,且并发症更少,可予以推广。

Objective To explore the clinical effect of minimally invasive distal gastric cancer surgery combined with D_(2) lymph node dissection in the treatment of gastric cancer.Methods A total of 76 patients with gastric cancer treated in our hospital from March 2018 to September 2020 were selected as the research objects.According to random number table method,the patients were divided into control group(traditional laparotomy + D_(2) lymph node dissection) and observation group(minimally invasive distal gastric cancer surgery + D_(2) lymph node dissection),with 38 cases in each group.The operation related indexes,radical effect,serum tumor markers indexes and postoperative complications were compared between the two groups.Results The operation time,postoperative exhaust time,out of bed activity time,hospital stay,time of eating liquid food and semi liquid food in the observation group were shorter than those in the control group,and the amount of intraoperative bleeding was less than that in the control group(P <0.05).There were no significant differences in the length of proximal and distal margin and the number of lymph nodes between the observation group and the control group(P>0.05).One week after operation,the level of serum PGⅠ of the two groups was higher than that before operation,the level of CA724 was lower than that before operation,and those in the observation group were better than the control group(P <0.05).The total incidence of complications in the observation group was 5.26%,which was lower than 23.68% in the control group(P<0.05).Conclusion Minimally invasive distal gastric cancer surgery combined with D_(2) lymph node dissection in the treatment of gastric cancer has the advantages of less trauma and rapid postoperative recovery.It can achieve the same effect as laparotomy,with fewer complications,which can be popularized.