摘要
目的通过比较腹腔镜辅助与传统开腹两种手术方式下的胃癌D2淋巴结清扫术对进展期胃癌手术治疗效果的差异,评价腹腔镜辅助在进展期胃癌手术中的临床应用价值。方法回顾性分析2010年8月—2014年10月皖南医学院弋矶山医院胃肠外科收治的406例确诊为进展期胃癌的患者,其中181例行腹腔镜辅助胃癌根治术(腹腔镜组),225例行传统开腹胃癌根治术(开腹组),观察2组患者在手术时间、术中出血量、淋巴结清扫数目、术后排气时间、术后住院天数、并发症发生率等指标的差异。结果 2组患者经临床治疗术中及术后指标比较情况:平均手术时间腹腔镜组为(239.3±144.1)min,开腹组为(218.3±138.7)min;术中平均出血量腹腔镜组为(163.3±32.1)ml,开腹组为(224.6±46.7)ml;清除淋巴结数目:腹腔镜组(17.6±2.2)个,开腹组为(18.4±1.9)个;术后肛门排气时间腹腔镜组为(3.4±0.6)d,开腹组为(4.4±0.7)d;术后平均住院时间腹腔镜组(9.4±0.7)d,开腹组为(11.1±0.9)d;手术时间腔镜组相对开腹组较长(P<0.05);淋巴结清扫数目2组间差异无统计学意义(P>0.05);并发症的发生率2组间差异无统计学意义(P>0.05);术中出血量腹腔镜组相对开腹组少(P<0.05)。2组术后恢复情况均是腹腔镜组优于开腹组(P<0.05)。结论腹腔镜辅助胃癌根治术同样可以达到开腹的手术效果,相比之下它还具有创伤小、出血少、恢复快等优势。
Objective To evaluate the clinical application value of laparoscopic assisted radical operation for gastric canc- er by comparing the therapeutic effect of D2 lymph node dissection between laparoscopic assisted and traditional open sur- gery. Methods Retrospective analyze clinical parameters of 406 confirmed patients of advanced gastric cancer in Gastro- intestinal Surgery Clinic of The First Affiliated Hospital of Wannan Medical College between August 2010 and October 2014,divide them in two groups：laparoscope group（ 181 cases） and open surgery group（225 cases） ,observe the differ- ences of operation time, bleeding volum, dissected lymph node number, postoperative exhaust time, postoperative hospital stay and complication rate between two groups. Results Compared with the open group, the operation time of laparoscop- ic gastrectomy longer [ （239.3 ± 144.1 ）min vs. （218.3 ± 138.7 ）min ,P 〈 0. 05 ] ,but the hemorrhage volume was less [ （ 163.3 ± 32.1 ） ml vs. （224.6 ±46.7 ） ml, P 〈 0.05 ], the anal exhaust time after operation was earlier [ （ 3.4 ± 0.6 ） d vs. （4.4 ±0.7） d,P 〈0.051 ,there were no differences in number of lymph nodes removed and complications between the two groups[ （ 17.6 ± 2.2 ） vs. （ 18.4 ± 1.9 ）, P 〉 0.05 ], the postoperative recovery in laparoscope group was better than that in open surgery group （ P 〈 0.05 ）. Conclusion The surgical treatment results of laparoscopic assisted radical opera- tion for gastric cancer were the same as open surgery. Compared with open surgery,laparoscopic assisted radical operation for gastric cancer showed advantages in operative trauma, blood loss and postoperative recovery time.
出处
《中华全科医学》
2015年第7期1060-1062,共3页
Chinese Journal of General Practice
基金
安徽省高校自然科学研究基金重点项目(KJ2011-A264)
安徽省芜湖市科技局课题(2010卫生4)
安徽省芜湖市科技计划重点项目(2014hm26)
关键词
腹腔镜辅助
开腹
进展期胃癌
D2淋巴结清扫
Laparoscopic assisted radical operation
Open surgery
Advanced gastric cancer
D2 lymph node dissection
作者简介
通信作者：史良会，E-mail：slh1020@163．com
