腹腔镜辅助胃癌D2根治术的临床疗效及其对腹腔微转移的影响  

The clinical effect of D2 gastric cancer radical operation assisted by laparoscopy and its effect on abdominal micrometastasis

作　　者：曾国祥[1] 黄文伟[1] 黄修仿 ZENG Guo-xiang;HUANG Wen-wei;HUANG Xiu-fang(Department of General Surgery,The People＇s Hospital of Hanchuan,Hanchuan Hubei 431600,China)

机构地区：[1]湖北省汉川市人民医院普外科,431600

出　　处：《蚌埠医学院学报》2018年第11期1450-1452,共3页Journal of Bengbu Medical College

摘　　要：目的:探讨腹腔镜辅助胃癌D2根治术的临床疗效及其对腹腔微转移的影响。方法:选取早期胃癌病人92例作为研究对象,将病人随机分为腹腔镜组和开腹组,各46例。腹腔镜组采用腹腔镜辅助胃癌D2根治术,开腹组实施传统开腹胃癌D2根治术。比较2组病人相关手术指标和手术前后的腹腔微转移指标。结果:腹腔镜组手术时间明显长于开腹组(P <0. 01),切口长度、术中出血量、下床活动时间、肠功能恢复时间及住院时间均少于开腹组(P <0. 05～P <0. 01),2组术中清扫淋巴结数差异无统计学意义(P> 0. 05)。2组病人术前多巴胺脱羧酶(DDC)和癌胚抗原(CEA)水平差异均无统计学意义(P>0. 05);术后2组病人DDC和CEA水平均明显高于术前(P <0. 01),腹腔镜组术后DDC和CEA水平均明显低于开腹组术后(P <0. 01)。结论:腹腔镜辅助胃癌D2根治术疗效确切,具有微创优势,术后腹腔微转移率低。Objective： To investigate the clinical effects of D2 gastric cancer radical operation assisted by laparoscopy,and its effect on abdominal micrometastasis. Methods： Ninety-two early gastric cancer patients were randomly divided into the laparoscopy group and laparotomy group（ 46 cases each group）. The laparoscopy group and laparotomy group were treated with gastric cancer radical operation assisted by laparoscopy and laparotomy,respectively. The clinical indicators and abdominal micrometastases index before and after operation between two groups were compared. Results： The operation time in laparoscopy group was significantly longer than that in laparotomy group（ P〈0. 01）,the incision length,intraoperative blood loss,out of bed activity time,intestinal function recovery time and hospital stay in laparoscopy group were less than those in laparotomy group（ P〈0. 05 to P〈0. 01）,and the difference of the number of intraoperative cleaning lymph node between two groups was not statistically significant（ P〉0. 05）. The differences of the levels of dopamine decarboxylase（ DDC） and carcinoembryonic antigen（ CEA） between two groups before operation were not statistically significant（ P〉0. 05）. After operation,the levels of DDC and CEA in two groups were significantly higher than those of before operation（ P〈0. 01）,and the levels of DDC and CEA in laparoscopy group were lower than those in laparotomy group（ P〈0. 01）. Conclusions：The curative effect of D2 gastric cancer radical operation assisted by laparoscopy is good,which is minimally invasive and has low postoperative abdominal micrometastasis.

关 键 词：胃肿瘤 胃癌D2根治术 腹腔镜 微转移 

分 类 号：R735.2[医药卫生—肿瘤]