新辅助化疗联合腹腔镜治疗进展期胃癌的近期疗效分析  

Comparision of the recent treatment effect between laparoscopic and open surgery following neoadjuvant chemortherapy for advanced gastric cancer

作　　者：王璟[1] 韩晓鹏[1] 苏琳[1] 李洪涛[1] 于建平[1] 李三党 刘宏斌[1] 

机构地区：[1]兰州军区兰州总医院普通外科,甘肃兰州730050

出　　处：《现代肿瘤医学》2014年第11期2632-2635,共4页Journal of Modern Oncology

基　　金：国家科技惠民计划项目(编号:2012GS620101);甘肃省科技重大专项(编号:2010GS04390)

摘　　要：目的:比较腹腔镜和开腹手术联合XELOX方案新辅助化疗治疗进展期胃癌的近期疗效。方法:对120例进展期胃癌患者在接受XELOX方案新辅助放化疗后,根据患者意愿分为腹腔镜手术组(68例)和开腹手术组(52例),比较两组患者的手术时间、术中出血量、淋巴结清扫数目、肿瘤距切缘距离、术后胃肠功能恢复时间、术后住院日和近期并发症发生率。结果:120例患者接受XELOX方案新辅助化疗后客观有效率为58.3%、临床获益率为86.7%;与开腹组比较,腹腔镜组手术时间延长,但术中出血量减少、术后胃肠功能恢复时间和术后住院日缩短,差异均有统计学意义(P<0.05);而淋巴结清扫数目、肿瘤距切缘距离以及术后并发症发生率差异均无统计学意义(P>0.05)。结论:进展期胃癌行XELOX方案新辅助化疗后行腹腔镜手术,术后恢复快,同时在淋巴结清扫方面与开腹手术有相同的效果。Objective：To compare the recent clinical effects of the laparoscopic and open surgery following with neoadjuvant chemotherapy of XELOX program for advanced gastric cancer.Methods：The clinical data of 120 patients with advanced gastric cancer received neoadjuvant chemotherapy of XELOX program,were divided into the laparoscopic surgery group（68 cases） and open surgery group （52 cases）.The data of operative time,intraoperative blood loss,number of dissected lymph nodes,distance from the tumor margin,intestinal functioning time,length of hospital stay,incidence of complications were compared between the two groups.Results：All 120 cases were given neoadjuvant chemotherapy of XELOX program.The response rate was 58.3%,and the clinical benefit rate was 86.7%.Compared with open surgery group,the operative time was prolonged,but the intraoperative blood loss was reduced,intestinal functioning time and length of hospital stay were shortened （all P 〈 0.05）.There were no significant differences in the number of dissected lymph nodes,distance from the tumor margin and incidence of complications between the two groups（all P 〉 0.05）.Conclusion：Compare to the patients with advanced gastric cancer received neoadjuvant chemoradiation therapy of XELOX program,laparoscopic surgery is better than open surgery in the safety and feasible procedure with quick recovery,and it is comparable with open gastrectomy in lymph node dissection.

关 键 词：胃癌 新辅助化疗 腹腔镜 XELOX 

分 类 号：R735.2[医药卫生—肿瘤]