腹腔镜辅助小切口胃癌根治术在进展期胃癌患者中的应用价值

The Application Value of Laparoscopic Assisted Small Incision Radical Gastrectomy in Patients with Advanced Gastric Cancer

目的探讨腹腔镜辅助小切口胃癌根治术在进展期胃癌患者中的应用价值。方法选取100例进展期胃癌患者为研究对象,采用随机数字法分为A组和B组,各50例,A组行开腹胃癌根治术,B组行腹腔镜辅助小切口胃癌根治术;比较两组患者围术期指标(手术时间、术中出血量、术后肛门排气时间、术后下床活动时间以及住院时间)、腹腔微转移指标[多巴脱羧酶(DDC)、癌胚抗原(CEA)]以及并发症。结果B组手术时间、术后肛门排气时间、术后下床活动时间以及住院时间短于A组,术中出血量少于A组,差异有统计学意义(P<0.05);治疗后2组DDC、CEA水平显著升高,但B组DDC、CEA水平均低于A组,差异有统计学意义(P<0.05);B组并发症发生率较A组低,差异有统计学意义(P<0.05)。结论腹腔镜辅助小切口胃癌根治术可有效改善进展期胃癌患者围术期指标,调节腹腔冲洗液DDC、CEA水平,降低并发症发生风险。

Objective To investigate the application value of laparoscope-assisted small incision radical gastrectomy in advanced gastric cancer patients.Methods 100 patients with advanced gastric cancer were selected as the study objects and divided into group A and group B by random number method,with 50 cases in each group.Group A received laparotomy radical gastrectomy,group B received laparoscopically assisted small incision radical gastrectomy.Perioperative indexes(operation time,intraoperative blood loss,postoperative anal exhaust time,postoperative activity time and hospital stay),intraperitoneal micrometastasis indexes(dopa decarboxylase(DDC),carcinoembryonic antigen(CEA))and complications were compared between the 2 groups.Results The operation time,postoperative anal exhaust time,postoperative movement time and hospital stay time of group B were shorter than those of group A,and the intraoperative blood loss was less than that of group A,the difference was statistically significant(P<0.05).After treatment,DDC and CEA levels in 2 groups were significantly increased,but DDC and CEA levels in group B were lower than those in group A,the difference was statistically significant(P<0.05).The incidence of complications in group B was lower than that in group A,and the difference was statistically significant(P<0.05).Conclusion Laparoscope-assisted radical resection of gastric cancer with small incision can effectively improve perioperative indexes,regulate DDC and CEA levels in peritoneal flushing fluid,and reduce the risk of complications in patients with advanced gastric cancer.