腹腔镜与开腹根治性全胃切除术治疗老年性Ⅱ、Ⅲ型胃食管结合部癌的近期疗效比较  

Comparison of short-term efficacy between laparoscopic radical total gastrectomy and open radical total gastrectomy in treatment of elderly patients with stage Ⅱ and Ⅲ gastroesophageal junction carcinoma

作　　者：苏志坚[1] 林周[1] 

机构地区：[1]江苏省无锡市第三人民医院,江苏无锡214000

出　　处：《实用临床医药杂志》2014年第21期85-87,91,共4页Journal of Clinical Medicine in Practice

摘　　要：目的比较腹腔镜与开腹根治性全胃切除术治疗老年性Ⅱ、Ⅲ型胃食管结合部癌的近期疗效。方法将在本院行腹腔镜根治性全胃切除术27例设为腹腔镜组,与同期55例行开腹根治性全胃切除术的开腹组患者进行临床疗效比较。结果2组清扫淋巴结数目无显著差异。腹腔镜组手术平均时间长于开腹组。腹腔镜组术中出血、切口长度及术后肛门排气时间、首次进流质时间、下床时间、术后C-反应蛋白降至正常时间低于开腹手术组。腹腔镜组肺部感染率低于开腹组,但差异无统计学意义,2组其他并发症比较无显著差异。结论腹腔镜根治术全胃切除术治疗老年性Ⅱ、Ⅲ型胃食管结合部癌较传统开腹手术耗时长,但疗效好,且具有耐受性好、创伤小、出血少、安全、术后恢复快等优点。Objective To compare the short - term efficacy between laparoscopic radical gastrectomy and open radical total gastrectomy in treatment of elderly patients with stage Ⅱ and Ⅲ gastroesophageal junction carcinoma. Methods 27 patients with laparoscopic radical gastrectomy were designed as laparoscopy surgery group, while 55 patients with open radical total gastrectomy were designed as open surgery group. Efficacy was compared between two groups. Results There was no significant difference of total retrieved lymph nodes between the two groups. The mean duration of laparoscopy surgery was （239.42 ±38.46） minutes, which was significantly longer than that of open surgery. Besides, the bleeding volume and incision length of laparoscopy surgery were （153.85 ±52.64） mL and （5.54 ±2.18） cm respectively. The time of anus exsufflation, first intake liquid diet, first postoperative ambulatory episode and postoperative Creactive protein dropping to normal level were significantly shorter than those of open surgery. Compared with open surgery, laparoscopy surgery had a lower pulmonary infection rate. There was no dramatic difference of other postoperative complications between the two groups. Conclusion In terms of achieving the same therapy effect, it takes a longer time to treat senile Ⅱ and Ⅲ gastroesophageal junction carcinomas by laparoscope - assisted total gastrectomy than by open radical total gastrectomy. However, it has advantages of better tolerance, fewer traumas, less bleeding, safer therapy and more rapid recovery by laparoscopeassisted total gastrectomy.

关 键 词：腹腔镜 根治性全胃切除术 胃食管结合部癌 老年人 

分 类 号：R735.2[医药卫生—肿瘤]