腹腔镜辅助胃癌根治术治疗进展期胃癌的临床疗效及近期预后观察

Clinical Efficacy and Short-term Prognosis of Laparoscopic-assisted Radical Gastrectomy for Advanced Gastric Cancer

目的研究腹腔镜辅助胃癌根治术治疗进展期胃癌的临床疗效及近期预后。方法选取2020年2月-2021年2月于盐城市第一人民医院收治的66例进展期胃癌患者,按照随机数字表法分为对照组(33例)与观察组(33例)。对照组行开腹胃癌根治术治疗,观察组行腹腔镜辅助胃癌根治术治疗,比较两组临床疗效、围术期指标、并发症发生率、微转移指标[腹腔冲洗液癌胚抗原(CEA)、多巴胺脱羧酶(DDC)]、近期预后情况[转移、复发、胃癌患者生活质量问卷(QLQ-ST022)评分]。结果观察组手术清扫淋巴结总数、远切端距肿瘤距离、近切端距肿瘤距离与对照组比较,差异无统计学意义(P>0.05);观察组手术时间、术后肛门排气时间、首次下床活动时间、术后住院时间均短于对照组,且术中出血量少于对照组(P<0.05);观察组并发症发生率低于对照组(P<0.05);观察组术后CEA、DDC水平低于对照组(P<0.05);术后6个月,两组转移、复发情况比较,差异无统计学意义(P>0.05),但观察组QLQ-ST022评分低于对照组(P<0.05)。结论腹腔镜辅助胃癌根治术治疗进展期胃癌的疗效确切,可在保证淋巴清扫效果的基础上,缩短手术及术后恢复时间,减少术中出血,降低并发症及潜在腹腔微转移风险,改善患者近期预后质量。

Objective To study the clinical efficacy and short-term prognosis of laparoscopic assisted radical gastrectomy for advanced gastric cancer.Methods A total of 66 patients with advanced gastric cancer admitted to Yancheng No.1 People's Hospital from February 2020 to February 2021 were selected and divided into control group(33 cases)and observation group(33 cases)according to random number table method.The control group was treated with open radical gastrectomy for gastric cancer,and the observation group was treated with laparoscopic assisted radical gastrectomy for gastric cancer.The clinical efficacy,perioperative indicators,incidence of complications,micrometastasis indicators[carcinoembryonic antigen(CEA),dopamine decarboxylase(DDC)],short-term prognosis[metastasis,recurrence,Quality of Life Questionnaire of Stomach 22(QLQ-ST022)score]were compared between the two groups.Results There was no significant difference in the total number of lymph nodes dissected,the distance from the distal cut end to the tumor,and the distance from the proximal cut end to the tumor between the observation group and the control group(P>0.05).The operation time,postoperative anal exhaust time,first ambulation time and postoperative hospital stay in the observation group were shorter than those in the control group,and the intraoperative blood loss was less than that in the control group(P<0.05).The incidence of complications in the observation group was lower than that in the control group(P<0.05).The levels of CEA and DDC in the observation group were lower than those in the control group(P<0.05).At 6 months after operation,there was no significant difference in metastasis and recurrence between the two groups(P>0.05),but the QLQ-ST022 score of the observation group was lower than that of the control group(P<0.05).Conclusion Laparoscopic assisted radical gastrectomy is effective in the treatment of advanced gastric cancer.On the basis of ensuring the effect of lymph node dissection,it can shorten the operation and postoperative recovery time,reduce intraoperative bleeding,reduce complications and potential risk of abdominal micrometastasis,and improve the quality of short-term prognosis of patients.