腹腔镜与开腹胃癌根治术远期疗效配对的病例对照研究  

A case-matched controlled study comparing the long-outcomes of open vs laparoscopy-assisted radacal gastrectomy

作　　者：丁祥飞[1] 卢榜裕[2] 

机构地区：[1]解放军181医院普外科,桂林市541002 [2]广西医科大学微创中心,南宁市530027

出　　处：《微创医学》2008年第5期437-440,共4页Journal of Minimally Invasive Medicine

摘　　要：目的比较腹腔镜与传统开腹胃癌根治术的远期疗效。方法对68例腹腔镜辅助胃癌根治术的患者临床及随访资料和同期在我院行传统开腹胃癌手术的68例进行回顾性配对的病例行对照研究。腹腔镜手术的病例作为实验组,开腹组作为对照组。比较两组的手术相关指标、术后并发症、生存率以及癌症复发转移情况。结果两组均无手术死亡病例。腹腔镜组手术时间显著长于开腹组[(286.1±52.9)minvs(226.4±37.5)min](P<0.05),术中出血量、术中输血量、术后血常规、肝功能变化、淋巴结清扫数目两组差异无统计学意义(P>0.05)。两组的手术并发症均较少。随访时间3～72个月,平均35个月,腹腔镜组1、3、5年生存率为74.55%、46.88%和45.45%,开腹组为70.90%、56.25%和36.36%,两组比较P>0.05,无统计学差异。癌症复发转移两组差异无统计学意义(P>0.05)。结论腹腔镜辅助胃癌根治术安全、有效,远期随访观察,腹腔镜组与开腹组在生存率及术后复发方面无显著差异。Objective Abstract Objective To compare long-outcomes between laparoscopic-assisted gastrectomy and open gastrectomy for the gastric cancer. Methods 68 cases of laparoscopy-assisted gastrectomy for gastric cancer were operated in our department from March 2002 to December 2007. The operative time, blood loss,lymph node haryested, operative complications and survival rate of these 68 cases were compared with those 68 cases of open radical resection of gastric cancer in the same period in our hospital as a retrospectively matching case-control study. Laparoscopic surgery cases are assigned to the experimental group and open surgery cases are assigned to the control group. Results No case had operation death in the 2 groups. Operation time in the Laparoscopic surgery group was significantly longer than that in the Open Group [ （ 286.1 ± 52.9） min vs （226.4 ± 37.5 ） min] （ P 〈 0.05 ）. Intraoperative blood loss, blood transfusion, blood routine and liver function around surgery and the number of lymph node dissection had no significant difference between the 2 groups（P 〉 0.05 ）. Operative complications in the two groups are less. The mean follow up was 35 months （ range 3 - 72 ）. In Laparoscopic Group the 1 - ,3 - and 5 - year survival rate was 74.55% ,46.88% ,45.45% and in Open Group was 70.90%, 56.25% ,36.36%. Survival rates between the two groups had no significant difference（ P 〉 0.05 ）. Rate of postoperative recurrent disease had no significant difference between the two groups （ P 〉 0.05 ）. Conclusion laparoscopic-assisted gastrectomy for gastric cancer is safe and effective. The rate of survival and recurrence is similar to open surgery in Long-term follow-up study.

关 键 词：腹腔镜 胃癌 淋巴结 配对研究 

分 类 号：R735.2[医药卫生—肿瘤]