腹腔镜辅助下远端胃癌根治术(D2)的临床效果  

Clinical effects of laparoscopic-assisted D2 radical gastrectomy for distal gastric carcinoma

作　　者：支永发[1] 高军林[2] 

机构地区：[1]青海红十字医院胃肠外科,青海省西宁市810000 [2]青海红十字医院普外科,青海省西宁市810000

出　　处：《世界华人消化杂志》2014年第25期3835-3838,共4页World Chinese Journal of Digestology

摘　　要：目的:分析腹腔镜辅助下胃癌D2根治术临床治疗效果.方法:收集2011-02/2014-02青海红十字医院收治的72例远端胃癌D2根治术患者临床资料,按照治疗方法不同,分为开腹组与腹腔镜组,每组均为36例.腹腔镜组患者采用腹腔镜辅助远端胃癌D2根治术治疗,开腹组患者采用开腹远端胃癌D2根治术治疗,比较两组患者手术指标、病理检查结果和并发症发生情况.结果:腹腔镜组患者手术出血量、术口长度、注射止痛药物次数、肛门排气时间、下床活动时间、住院时间明显少于开腹组(130.84 mL±51.73 mL vs 335.96 mL±85.86mL,5.84 cm±0.34 cm vs 21.83 cm±2.67 cm,1.75次±1.32次vs 4.96次±1.45次,3.87 d±1.73 d vs 6.75 d±1.24 d,3.95 d±1.11 d vs 5.86d±1.94 d,11.73 d±4.67 d vs 15.93 d±7.95 d),手术时间明显长于开腹组(289.94 min±30.84min vs 235.85 min±29.11 min),差异有显著意义(P<0.05);在清扫淋巴结数量、肿瘤上切缘长度以及肿瘤下切缘长度方面(30.72枚±10.64枚vs 31.24枚±11.73枚,7.73 cm±2.44cm vs 7.82 cm±1.73 cm,7.96 cm±2.84 cm vs7.21 cm±2.01 cm),两组患者对比,差异无显著意义(P>0.05);腹腔镜组并发症发生率为8.33%,明显低于开腹组的22.22%,差异有显著意义(P<0.05).结论:腹腔镜辅助远端胃癌D2根治术具有明显的安全性,见效快,创伤小,促进患者术后恢复,彻底清除病灶,改善患者预后情况,值得临床推广.AIM： To assess the clinical effects of laparoscopic-assisted D2 radical gastrectomy for distal gastric carcinoma.METHODS： Seventy-two patients who underwent D2 radical gastrectomy for distal gastric carcinoma were divided into either a laparotomy group（n = 36） or a laparoscopic surgery group（n = 36）. The laparoscopic surgery group received laparoscopic-assisted D2 radical gastrectomy, while the laparotomy group received laparotomy for D2 radical gastrectomy. The operation indicators, pathological findings and complications were compared between the two groups.RESULTS： The bleeding volume, length of the incision, times of injection of analgesic drugs, time to anal exsufflation, postoperative stay inbed, and length of hospital stay were significantly better in the laparoscopic surgery group than in the laparotomy group（130.84 mL ± 51.73 mL vs 335.96 mL ± 85.86 mL, 5.84 cm ± 0.34 cm vs 21.83 cm ± 2.67 cm, 1.75 ± 1.32 vs 4.96 ± 1.45, 3.87 d ± 1.73 d vs 6.75 d ± 1.24 d, 3.95 d ± 1.11 d vs 5.86 d ± 1.94 d, 11.73 d ± 4.67 d vs 15.93 d ± 7.95 d, P 0.05）. The operative time was longer in the laparoscopic surgery group than in the laparotomy group（289.94 min ± 30.84 min vs 235.85 min ± 29.11 min, P 0.05）. There were no significant differences in the number of cleared lymph nodes or the length of upper or lower resection margin（30.72 ± 10.64 vs 31.24 ± 11.73, 7.73 cm ± 2.44 cm vs 7.82 cm ± 1.73 cm, 7.96 cm ± 2.84 cm vs 7.21 cm ± 2.01 cm, P 0.05）. The rate of complications was significantly lower in the laparoscopic surgery group than in the laparotomy group（8.33% vs 22.22%, P 0.05）.CONCLUSION： Laparoscopic-assisted D2 radical gastrectomy for distal gastric carcinoma is safe, effective and minimally invasive, and can promote postoperative recovery, remove the lesions thoroughly, and improve prognosis.

关 键 词：腹腔镜 开腹 远端胃癌 D2根治术 

分 类 号：R735.2[医药卫生—肿瘤]