远端胃癌腹腔镜D2根治术与传统开腹术近期疗效观察

Observation on short-term efficacy between laparoscopy-assisted D2 radical gastrectomy and conventional open surgery for distal gastric cancer

摘要:

目的：对比分析远端胃癌腹腔镜D2根治术与传统开腹术的临床近期疗效，探讨腹腔镜D2根治术的应用价值。方法：选取本院2008年12月至2012年3月胃癌患者60例，行腹腔镜手术患者30例为观察组；行传统开腹手术患者30例为对照组。观察比较两组患者切口长度、手术时间、术中出血量、首次肛门排气时间、清扫淋巴结数、术后住院时间、术后并发症等临床疗效指标。结果：腹腔镜组/开腹组：切口长度（5.98±1.56） cm/（13.02±2.15） cm（t=14.52，P=0.000）；手术时间：（189.02±13.78）min/（150.58±15.31） min（t=10.22，P=0.000）；术中出血量：（100.89±23.03） ml/（156.36±30.37） ml（t=7.97，P=0.000）；首次肛门排气时间：（3.67±1.56） d/（5.04±2.08） d（t=2.89，P=0.005）；淋巴结清扫数：（18.87±5.03）枚/（17.03±3.67）枚（t=1.62，P=0.011）；术后住院时间:（10.58±3.17） d/（13.59±4.36） d（t=3.06，P=0.003）。组间差异均具有统计学意义。结论：腹腔镜辅助远端胃癌D2根治术较传统的开腹手术治疗在临床近期疗效方面具有较大的优势。

Abstract:

Objective：To compare the short-term efficacy between laparoscopy-assisted D2 radical gastrectomy and conventional open surgery for early distal gastric cancer and to explore the value of laparoscopy-assisted D2 radical gastrectomy. Methods：Sixty patients with distal gastric cancer from December 2008 to March 2012 were enrolled；30 patients received laparoscopy-assisted surgery were taken as observation group while 30 patients underwent conventional open surgery as control group. Length of incision，operation time，intraoperative blood loss，the first anal exhausting time，numbers of dissected lymph node，postoperative complications，postoperative hospital duration were observed and compared. Results：Observation group vs. control group: length of incision（5.98±1.56） cm vs.（13.02 ±2.15） cm（P=0.000）；operation time （189.02±13.78） min vs. （150.58±15.31） min（P=0.000）；intraoperative blood loss （100.89±23.03） ml vs. （156.36 ±30.37） ml （P=0.000）；the first anal exhausting time（3.67±1.56） d vs. （5.04±2.08） d（P=0.005）；numbers of dissected lymph node （18.87±5.03） vs. （17.03±3.67）（P=0.011）；postoperative hospital duration（10.58±3.17） d vs. （13.59±4.36） d（P=0.003）. Differences between groups were all of statistical significances. Conclusions：Laparoscopic-assisted D2 radical gastrectomy has more advantages than coventional open surgery in the treatment of distal gastric cancer.