腹腔镜辅助D2式胃癌根治术治疗老年进展期胃癌临床观察

Laparoscopic assisted D2 radical gastrectomy for gastric cancer in elderly patients

目的探讨老年进展期胃癌患者行腹腔镜辅助D2式胃癌根治术的临床疗效和安全性。方法 94例老年进展期胃癌患者,行腹腔镜辅助D2式胃癌根治术49例为腹腔镜组,行开腹D2式胃癌根治术45例为开腹组。比较2组手术时间、术中出血量、术后下床时间、术后排气时间及住院时间,记录并发症发生情况。结果腹腔镜组手术时间[(232.1±51.3)min]较开腹组[(207.4±53.2)min]长,术中出血量[(112.5±35.3)mL]较开腹组[(191.8±74.9)mL]少,术后下床时间[(3.0±1.4)d]、术后排气时间[(2.5±0.4)d]较开腹组[(7.2±1.5)、(3.6±0.9)d]早,住院时间[(12.7±6.5)d]较开腹组[(15.5±7.0)d]短(P<0.05);腹腔镜组术后并发症发生率(10.2%)低于开腹组(28.9%)(P<0.05)。结论对老年进展期胃癌患者,行腹腔镜胃癌D2式根治术可减少术中出血量,促进术后恢复,减少术后并发症。

Objective To investigate the clinical efficacy and safety of laparoscopic assisted D2 radical gastrectomy in the treatment of advanced gastric cancer in elderly patients.Methods Ninety-four elderly patients with advanced gastric cancer were treated with laparoscopic assisted D2 radical gastrectomy in 49 patients(laparoscopy group)and open D2 radical gastrectomy in 45 patients(open group).The operative time,intraoperative blood loss,postoperative off-bed time,postoperative exhaust time and hospital stay were compared between two groups and the adverse reactions were recorded.Results Laparoscopy group has longer operative time((232.1±51.3)min),less intraoperative blood loss((112.5±35.3)mL),earlier off-bed time((3.0±1.4)d)and exhaust time((2.5±0.4)d),shorter hospital stay((12.7±6.5)d),and lower rate of adverse reactions(10.2%)compared with open group((207.4±53.2)min,(191.8±74.9)mL,(7.2±1.5)d,(3.6±0.9)d,(15.5±7.0)d,28.9%)(P<0.05).Conclusion For elderly patients with advanced gastric cancer,laparoscopic assisted D2 radical gastrectomy can reduce intraoperative blood loss,promote postoperative recovery and reduce postoperative complications.