腹腔镜辅助与开腹远端胃癌D2根治术对比分析  

Clinical Comparative Analysis of Laparoscopy-assisted and Open Radical Gastrectomy for Distal Gastric Cancer

作　　者：芦灵军[1] 黄君[1] 易先武[1] 陈伟平[1] 王伟[1] 樊建新[1] 徐其银[1] 

机构地区：[1]宜宾市第一人民医院普外科,四川宜宾644000

出　　处：《四川医学》2015年第9期1287-1290,共4页Sichuan Medical Journal

摘　　要：目的评价腹腔镜辅助远端胃癌D2根治术的安全性、可行性及疗效。方法回顾性分析2009年9月至2012年7月54例行远端胃癌D2根治术患者的临床资料,其中26例行腹腔镜辅助胃癌D2根治术,28例行常规开腹根治术。比较两组手术时间、术中出血量、淋巴结清扫数量、手术并发症、术后住院时间等情况,分析患者术后生存率。结果腹腔镜组平均手术时间长于开腹组,术中出血量、术后住院时间少于开腹组,差异有统计学意义(P<0.05);两组间清扫淋巴结数量、术后并发症发生率差异无统计学意义(P>0.05)。中位随访时间29个月,腹腔镜组的1、2、3年总生存率分别是92.2%、78.3%和46.2%,开腹组的1、2、3年总生存率分别是88.3%、75.7%和48.3%,两组间差异无统计学意义(P>0.05)。结论腹腔镜辅助远端胃癌D2根治术安全、可行,其中期疗效与开腹手术相当。Objective To evaluate the safety, feasibility and efficacy of laparoscopy-assisted gastrectomy with D2 lymph node dissection for distal gastric cancer. Methods Clinical date of 54 patients with distal gastric cancer undergoing gastrectomy with D2 lymph node dissection from September 2009 to July 2012 were retrospectively analyzed. Among the patients, 26 cases underwent laparoscopy-assisted gastrectomy（ laparoscopic group） and 28 cases open distal gastrectomy （ open surgery group） in the same period. The operation time, intraoperative blood loss, number of lymph nodes dissection, postoperative complication, length of postoperative hospital stay and survival rate were analyzed. Results The operation time of the laparoscopic group was longer than that of the open surgery group （P〈0. 05）. The intraoperative blood loss and length of postoperative hospital stay of the laparoscopic group less than that of the open surgery group （ P〈0. 05 ） . There were no statistically significant differences in number of lymph nodes dissection and postoperative complication. The medium follow up period were 29 months. The overall 1, 2, 3-year survival rates of laparoscopic group was 92. 2%、78. 3% and 46. 2%, respectively. The survival rates of open surgery group were 88. 3%、75. 7% and 48. 3%. The difference were no statistically significant （P〉0. 05）. Conclusion Laparoscopy-assisted gastrectomy with D2 lymph node dissec-tion is safe and feasible for distal gastric cancer and its medium-term outcome consistent with open surgery.

关 键 词：胃肿瘤 腹腔镜 远端胃癌根治术 开腹手术 

分 类 号：R735.2[医药卫生—肿瘤]