两种胃癌根治术治疗早期胃癌的临床疗效比较  

Comparison of clinical efficacy of two types of radical gastrectomy for treatment of early gastric cancer

作　　者：何永林[1] 郑本波[1] 李峰[1] 

机构地区：[1]四川省德阳市人民医院普通外科,四川德阳618000

出　　处：《中国普通外科杂志》2011年第12期1376-1379,共4页China Journal of General Surgery

摘　　要：目的比较腹腔镜与传统开腹胃癌根治术治疗早期胃癌的临床疗效。方法回顾性分析2006年2月—2011年2月接受手术治疗的112例早期胃癌患者的临床资料,包括腹腔镜胃癌根治术(腹腔镜组)55例和开腹胃癌根治术(开腹组)57例。比较两组手术时间、术中出血量、肿瘤切缘、术后肛门排气时间、术后进食流质时间、术后住院天数、术后并发症、病理结果及随访等。结果腹腔镜组手术时间(196.5±48.9)min,术中出血量(142.3±142.7)mL,肛门排气时间(2.8±1.1)d,术后进食流质时间(5.1±1.8)d,术后住院天数(10.3±1.1)d,均显著低于开腹组[分别为(216.8±47.1)min,(246.0±148.4)mL,(4.5±1.5)d,(7.2±3.4)d,(13.2±3.6)d](均P<0.05)。腹腔镜组肿瘤上下切缘[(4.1±1.6),(3.5±1.5)cm],术中清扫淋巴结数[(13.2±6.9)枚],术后并发症发生率(9.1%)与开腹组[(4.0±1.8,3.6±1.7)cm,(14.3±7.7)枚,10.5%]比较差异均无统计学意义(均P>0.05)。术后腹腔镜组中位随访24(2～66)个月,未发现肿瘤复发及远处转移;开腹组中位随访23(2～63)个月,1例因肿瘤腹膜转移死亡。结论腹腔镜根治术治疗早期胃癌安全有效,与开腹根治术相比具有微创、手术时间短、术后胃肠功能恢复快、术后住院天数少等优点。Objective To compare the clinical efficacy of laparoscopy-assisted gastrectomy and conventional open gastrectomy in treatment of early gastric cancer（EGC）.Methods The clinical data of 112 EGC patients undergoing surgical treatment at our department from February 2006 to February 2011 were retrospectively analyzed.Of the patients,55 cases underwent laparoscopy-assisted gastrectomy（laparoscopy group） and 57 cases underwent open gastrectomy（open surgery group）.The operative time,blood loss,tumor resection margins,and the time to flatus passage,starting time of the liquid diet,hospital stay and complications after surgery,as well as the pathological findings and follow-up data between the two groups were compared.Results The operative time [（196.5±48.9） min],blood loss [（142.3±142.7） mL],postoperative flatus passage time [（2.8±1.1） d],starting time of the liquid diet [（5.1±1.8） d] and postoperative hospital stay [（10.3±1.1） d] of the laparoscopy group were significantly reduced compared with those of the open surgery group [（216.8±47.1） min,（246.0±148.4） mL,（4.5±1.5） d,（7.2±3.4） d and（13.2±3.6） d]（all P0.05）.No statistical difference was noted in tumor resection margins,number of lymph nodes removed,postoperative complication incidence [（4.1±1.6） cm/（3.5±1.5） cm,（13.2±6.9）,9.1% vs.（4.0±1.8） cm/（3.6±1.7） cm,（14.3±7.7）,10.5%] between the two groups（all P0.05）.No tumor recurrence or metastasis occurred in the laparoscopy group during a median follow-up period of 24（2-66） months,while one patient died of peritoneal metastasis in the open surgery group during a median follow-up period of 23（2-63） months.Conclusions Laparoscopy-assisted radical gastrectomy is safe and effective for EGC,and it has the advantages of minimally invasive,less operative time,quick recovery of postoperative gastrointestinal function and short postoperative hospital stay compared with open radical gastrectomy.

关 键 词：胃肿瘤/外科学 腹腔镜 对比研究 

分 类 号：R735.2[医药卫生—肿瘤]