腹腔镜辅助D2式胃癌根治术治疗老年进展期胃癌患者的临床疗效和安全性

Clinical efficacy and safety of laparoscopic-assisted D2 radical gastrectomy for elderly patients with advanced gastric cancer

目的探讨腹腔镜辅助D2式胃癌根治术治疗老年进展期胃癌患者的临床疗效和安全性。方法选取2018年1月至2020年12月本院收治的190例进展期胃癌老年患者作为研究对象,按手术治疗方式不同分为对照组和研究组,每组95例。对照组采用常规开腹手术治疗,研究组采用腹腔镜辅助D2胃癌根治术治疗,比较两组临床疗效、围手术期指标(手术时间、手术出血量、住院时间、术后进食时间和术后下床活动时间)及术后并发症发生情况。结果研究组治疗总有效率为93.68%,高于对照组的81.05%,差异有统计学意义(P<0.05)。研究组住院时间、术后进食时间、术后下床活动时间、手术时间均短于对照组,手术出血量少于对照组,差异有统计学意义(P<0.05)。研究组术后并发症发生率为15.79%,低于对照组的32.63%,差异有统计学意义(P<0.05)。结论腹腔镜辅助D2式胃癌根治术治疗老年进展期胃癌的效果显著,可缩短患者术后恢复时间,减少并发症的发生,安全性较高,值得临床推广应用。

Objective To investigate the clinical efficacy and safety of laparoscopic-assisted D2 radical gastrectomy for elderly patients with advanced gastric cancer.Methods A total of 190 elderly patients with advanced gastric cancer treated from January 2018 to December 2020 were selected as the study subjects,and they were divided into control group and study group according to different surgical treatment methods,with 95 patients in each group.The control group were treated with conventional open surgery,and the study group were treated with laparoscopic-assisted D2 radical gastrectomy,the clinical efficacy,perioperative indicators(operation time,operative blood loss,hospitalization time,postoperative feeding time and postoperative ambulation time)and postoperative complications were compared between the two groups.Results The total effective rate of the study group was 93.68%,which was higher than 81.05%of the control group,and the difference was statistically significant(P<0.05).The hospitalization time,postoperative feeding time,postoperative ambulation time and operation time of the study group were all shorter than those of the control group,and operative blood loss was less than that of the control group,and the differences were statistically significant(P<0.05).The incidence of postoperative complications in the study group was 15.79%,which was lower than 32.63%in the control group,and the difference was statistically significant(P<0.05).Conclusion Laparoscopic-assisted D2 radical gastrectomy for advanced gastric cancer in the elderly has significant effect,which can reduce the postoperative recovery time of patients,and reduce the occurrence of complications,and has high safety,which is worthy of clinical application.