全腹腔镜与腹腔镜辅助胃癌根治术治疗局部进展期远端胃癌的效果比较

Comparison of effects of total laparoscopic and laparoscopic assisted radical gastrectomy on locally advanced distal gastric cancer

目的比较全腹腔镜与腹腔镜辅助胃癌根治术治疗局部进展期远端胃癌的效果。方法根据手术方法将142例局部进展期远端胃癌患者分为对照组和观察组,每组71例。对照组采取腹腔镜辅助胃癌根治术,观察组采取全腹腔镜胃癌根治术。比较两组的治疗效果。结果观察组的手术时间及住院时间短于对照组,术中出血量少于对照组(P<0.05)。观察组术后1周的视觉模拟评分法(VAS)评分显著低于对照组,切口满意度评分显著高于对照组(P<0.05)。两组术后1个月并发症总发生率比较,差异无统计学意义(P>0.05)。术后1周,观察组的白细胞分化抗原4阳性(CD4^(+))高于对照组,白细胞分化抗原8阳性(CD8^(+))低于对照组,CD4^(+)/CD8^(+)高于对照组(P<0.05)。结论全腹腔镜胃癌根治术治疗局部进展期远端胃癌的近期效果优于腹腔镜辅助胃癌根治术,但二者的并发症发生率类似。

Objective To compare the effects of total laparoscopic and laparoscopic assisted radical gastrectomy on locally advanced distal gastric cancer.Methods One hundred and forty-two patients with locally advanced distal gastric cancer were divided into control group and observation group according to the operation method,with 71 cases in each group.The control group was treated with laparoscopic assisted radical gastrectomy,while the observation group was treated with total laparoscopic radical gastrectomy.The therapeutic effects of the two groups were compared.Results The operation time and hospital stay of the observation group were shorter than those of the control group,and the amount of intraoperative bleeding was less than that of the control group(P<0.05).The visual analogue scale(VAS)score of the observation group was significantly lower than that of the control group at one week after operation,while the incision satisfaction score was significantly higher than that of the control group(P<0.05).There was no significant difference in the total incidence of complications at one month after operation between the two groups(P>0.05).One week after operation,cluster of differentiation 4 positive(CD4^(+))in the observation group was higher than that in the control group,cluster of differentiation 8 positive(CD8^(+))was lower than that in the control group,and CD4^(+)/CD8^(+)was higher than that in the control group(P<0.05).Conclusion The short-term effect of total laparoscopic radical gastrectomy for locally advanced distal gastric cancer is better than that of laparoscopic assisted radical gastrectomy,but their incidence of complications are similar.