腹腔镜与开腹胃癌根治术治疗进展期胃癌的临床对比研究

Clinical comparative study of laparoscopy-assisted radical gastrectomy and open radical gastrectomy for advanced gastric cancer

目的分析进展期胃癌采用腹腔镜辅助胃癌根治术治疗的效果和安全性。方法40例进展期胃癌患者,根据手术术式不同分为观察组和对照组,各20例。观察组给予腹腔镜胃癌根治术治疗,对照组给予开腹胃癌根治术治疗。比较两组患者临床指标(镇痛药使用次数、首次直肠排气时间、首次经口进流食时间、胃肠减压停止时间、腹腔引流停止时间、住院时间)及并发症发生率。结果观察组镇痛药使用次数(3.31±1.27)次少于对照组的(7.64±3.25)次,首次直肠排气时间(4.24±0.83)d、首次经口进流食时间(8.41±2.86)d、胃肠减压停止时间(4.75±2.41)d、腹腔引流停止时间(9.79±2.55)d、住院时间(13.82±3.06)d均短于对照组的(6.03±0.96)、(10.62±3.79)、(7.46±2.14)、(12.15±3.91)、(17.34±4.37)d,差异有统计学意义(P<0.05)。观察组术后并发症发生率15.0%低于对照组的55.0%,差异有统计学意义(P<0.05)。结论腹腔镜胃癌根治术治疗进展期胃癌可有效改善患者相关指标,并发症较少,临床安全有效,具有良好的微创效果。

Objective To analyze the effect and safety of laparoscopy-assisted radical gastrectomy and open radical gastrectomy for advanced gastric cancer.Methods A total of 40 patients with advanced gastric cancer were divided into observation group and control group according to different surgical methods,with 20 patients in each group.The observation group was treated with laparoscopy-assisted radical gastrectomy,while the control group was treated with open radical gastrectomy.Both groups were compared in terms of clinical indicators(number of analgesics used,time to first rectal evacuation,time to first oral feeding,time to cessation of gastrointestinal decompression,time to cessation of abdominal drainage,and length of hospital stay),and incidence of complications.Results The number of analgesics used of(3.31±1.27)times in the observation group was less than that of(7.64±3.25)times in the control group;in the observation group,the time to first rectal evacuation was(4.24±0.83)d,the time to first oral feeding was(8.41±2.86)d,the time to cessation of gastrointestinal decompression was(4.75±2.41)d,the time to cessation of abdominal drainage was(9.79±2.55)d,and the length of hospital stay was(13.82±3.06)d,which were shorter than those of(6.03±0.96),(10.62±3.79),(7.46±2.14),(12.15±3.91),and(17.34±4.37)d in the control group;the differences were statistically significant(P<0.05).The incidence of postoperative complications of 15.0%in the observation group was lower than that of 55.0%in the control group,and the difference was statistically significant(P<0.05).Conclusion Laparoscopy-assisted radical gastrectomy in the treatment of advanced gastric cancer can effectively improve the relevant indicators of patients with fewer complications,and is clinically safe and effective with good minimally invasive effects.