腹腔镜与开腹胃癌根治术的临床对照研究  

Case-matched controlled trial of laparoscopic surgery and open surgery for carcinoma of stomach

作　　者：陈建安[1] 王晓华[1] 张金成[1] 陈勇 

机构地区：[1]南方医科大学附属小榄医院肿瘤外科,广东中山528415

出　　处：《中国内镜杂志》2013年第9期923-926,共4页China Journal of Endoscopy

基　　金：中山市科技攻关计划(No.20082A094)

摘　　要：目的比较腹腔镜与传统开腹胃癌根治术在胃癌治疗中的近期效果。方法2008年9月一2011年9月因胃癌而在该院行腹腔镜手术12例和同期在该院行传统开腹手术12例进行对照研究。比较两组的手术相关指标、术后恢复指标及肿瘤根治程度。结果两组均无切缘癌残留、吻合口漏和手术死亡病例。腹腔镜组手术时间长于开腹组（中位数355minVS221min，Z=2．252，P=0．041）。术后使用止痛药物腹腔镜组优于开腹组【（1．5±1．4）次vs（3．1±1．9）次，Z=4．22，P=0．01】，而术中出血量（中位数231mLVS137mL，Z=I．218，P=0．138）、术后血常规、肝功能变化、淋巴结清扫数目[（18．3±9．2）枚vs（16．9±8．5）枚，t=O．680，P=0．523）两组差异无显著性（P〉0．05）。结论腹腔镜胃癌根治术安全、有效，近期效果与传统开腹手术基本无异，可在临床推广应用。[Objective] To compare short-term effects between laparoscopic and open radical gastrectomy. [Methods] The clinical data of 12 cases performed by laparoscopie surgery （Laparoscope Group） from September 2008 to September 2011 and 12 cases performed by open surgery （Open Group） at the same period in our hospital were compared. Operation-related index, postoperative recovery and extent of radical resection of tumors in the 2 groups were compared. [Results] No case had residual tumor in incisal margin, intestine leakage and operation death in the 2 groups. Operation time in the Laparoscope Group was longer than that in the Open Group （median 355 min vs 221 min, Z=2.252, P =0.041）. Postoperative administration of analgetic in the Laparoscope Group sur- passed that in the Open Group [（1.5±1.4） times vs （3.1±1.9） times, Z=4.22, P =0.01], but intraoperative blood loss （median 231 mL vs 275 mL, Z=1.218, P =0.138）, and blood routine and hepatic function before and after operation, clearance number of lymphnodes [（18.3±9.2） vs （16.9±8.5）, t=0.680, P =0.523] had no significant difference between the 2 groups （P 〉0.05）. [ Conclusions ] Laparoscopic radical gastrectomy for gastric cancer is safe and effective, and its short-term outcome is similar to open surgery.

关 键 词：胃癌 腹腔镜 胃癌根治术 

分 类 号：R735.2[医药卫生—肿瘤]