局部晚期胃癌应用开腹与腹腔镜手术治疗的临床疗效分析  

Comparative clinical laparotomy and laparoscopy in locally advanced gastric cancer

作　　者：张浩[1] 汤雪峰[1] 刘岗[1] 张熹玮[1] 黄建平[1] 

机构地区：[1]上海中医药大学附属曙光医院普外科,上海200092

出　　处：《中国医刊》2016年第5期58-61,共4页Chinese Journal of Medicine

基　　金：上海市医药卫生发展基金(2015114985)

摘　　要：目的探讨开腹胃癌根治手术与腹腔镜下胃癌根治手术在局部晚期胃癌患者中的疗效及安全性。方法选取本院肿瘤科收治的局部晚期胃癌行腹腔镜辅助胃癌根治术的患者50例作为观察组,以及同期40例行传统开腹胃癌手术的患者为对照组,比较两组患者的围术期相关指标、术后恢复情况、根治程度、远期疗效以及并发症发生情况。结果观察组患者手术时间较对照组延长,术中出血量较对照组明显降低,差异均具有显著性(P<0.05);在淋巴结清扫范围以及消化道重建方式方面,两组患者间差异无显著性(P>0.05);与对照组相比,观察组患者使用镇痛剂时间、首次肛门排气时间、术后首次下床活动时间、进食时间以及术后住院天数明显缩短,差异有显著性(P<0.05);且观察组患者术后并发症发生率(8%)低于对照组(12.5%),但差异无显著性(P>0.05);观察组两年生存率高于对照组,但差异无显著性(P>0.05);在肿瘤部位、切缘长度、组织学类型、淋巴结检出数目及TNM等方面两组差异均无显著性(P>0.05);但对照组患者的肿瘤最大径较观察组大,差异具有显著性(P<0.05)。结论在局部晚期胃癌患者行腹腔镜下胃癌根治术,较传统开腹手术对患者产生的创伤较小,住院时间明显缩短,患者术后恢复迅速,但术后根治程度、远期生存率以及并发症发生情况未见明显差异。Objective To investigate gastric cancer under open surgery and laparoscopic gastric cancer surgery in patients with locally advanced gastric cancer in efficacy and safety. Method Oncology hospital treated locally advanced gastric laparoscopic assisted radical gastrectomy as the observation group, 50 patients, and 40 patients with the same period of the routine traditional open surgery for gastric cancer in the control group, two groups were compared perioperative related indicators, postoperative recovery, the degree of cure, long- term efficacy and complications were observed. Result Laparoscopic surgery time than the observation group were open to extend the control group, blood loss than open a control group was significantly lower, the difference was significant （P〈0.05）; lymph node dissection and gastric reconstruction side, two between the groups was not significantly different in patients with no significant difference （P〉 0.05）; compared with the open group, laparoscopy patients using analgesics time, first time anal exhaust time, postoperative ambulation first time, eating time and postoperative hospital stay was significantly shorter, the difference was statistically significant （P〈0.05）; and postoperative complication rate of less than 8% of patients in the laparoscopic group open group, 12.5% of postoperative complications, but the difference was not significant, no statistics significance （P〉 0.05）; after two years of follow-up, two-year survival rate was higher in the laparoscopic group two years survival rate, but the difference was not significant （P^0.05）; at the tumor site, margin length, histology type, node identification number and other aspects TNM laparoscopic group and laparotomy group showed no significant difference （P^0.05）; but the maximum tumor diameter laparotomy patients than big laparoscopic group, the difference was statistically significant （P〉0.05）. Conclusion In patients with locally advanced gastric cancer underwent laparoscopic gastrectom

关 键 词：胃癌 腹腔镜 胃切除术 

分 类 号：R735.2[医药卫生—肿瘤]