腹腔镜辅助下远端胃癌D2根治术治疗进展期胃癌的疗效及安全性  

Efficacy and safety of laparoscopy-assisted distal gastric resection D2 in treatment of advanced gastric cancer

作　　者：汤兴华[1] 刘雄[1] 章宜兰[1] 鲁明骞[2] 文彩虹[2] 

机构地区：[1]三峡大学第一临床医学院,宜昌市中心人民医院急诊科,宜昌443003 [2]三峡大学第一临床医学院,宜昌市中心人民医院肿瘤科,宜昌443003

出　　处：《中国肿瘤临床与康复》2015年第6期656-658,共3页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的探讨腹腔镜辅助下远端胃癌D2根治术治疗进展期胃癌的疗效及安全性。方法选择宜昌市中心人民医院2010年8月至2013年8月间收治的68例进展期胃癌患者,按照临床前瞻性研究原则将患者分为腹腔镜治疗组(观察组)和远端胃癌D2根治术治疗组(对照组),观察两组患者手术相关指标、术后恢复情况以及治疗效果。结果与对照组比较,观察组患者的手术时间、切口长度、术中出血量、术后肛门排气时间、下床活动时间、进流质饮食时间、住院时间以及并发症中的切口感染、吻合口瘘的发生率均明显降低,差异均有统计学意义(均P<0.05)。但清扫淋巴结总数、远切端距肿瘤距离均降低,近切端距肿瘤距离则增加,但差异无统计学意义(P>0.05)。两组患者的存活率比较,差异无统计学意义(P>0.05)。结论腹腔镜辅助下远端胃癌D2根治术治疗进展期胃癌安全、有效,可达到与开腹手术相当的根治效果,近期疗效甚佳,并发症较少。Objective To discuss the efficacy and safety of laparoscopy-assisted distal gastric re- section D2 in treatment of advanced gastric cancer Methods From August 2010 to August 2013, 68 ad- vanced gastric carcinoma patients who were treated in Yichang Central People＇s Hospital were enrolled in the study and randomly divided into laparoscope treatment group （observation group） and distal gastric cancer D2 radical correction treatment group （control group）. The operation relax indexes, postoperative recover status and curative effect were compared. Results Compared with control group, the operation duration, incision length, operative blood loss, postoperative anal exhaust time, the bed activity time, liquid diet time, hospital stay and complication incidence rate of incision infection, anastomotic leak of the observation group all obviously decreased, with significant differences （ P 〈 0. 05 ）. But the total number of lymph node dissection, far cut end distance from tumour all decreased, then near cut end distance from tumor in- creased, with significant differences （P 〉 0.05 ）. Survival between the two groups had no significant differ- ence （P 〉 0.05）. Conclusions Laparoscopy-assisted distal gastric resection D2 in treatment of advanced gastric cancer is safe and can achieve good curative effect.

关 键 词：进展期胃癌 远端胃癌D2根治术 腹腔镜 疗效 安全性 

分 类 号：R735.2[医药卫生—肿瘤]