腹腔镜辅助远端胃癌根治术对进展期胃癌的近期临床疗效分析  

The Short-term Curative Effect of Laparoscopic-assisted Distal D2 Radical Gastrectomy for Advanced Gastric Cancer

作　　者：韩复[1] 徐亮[2] 周国强[1] HAN Fu;XU Liang;ZHOU Guo-qiang(Department of Gastrointestinal Surgery,the Second People's Hospital of Changshu,Changshu,Jiangsu,215500,China;Department of Gastrointestinal Surgery,Changshu Hospital of Traditional Chinese Medicine,Changshu,Jiangsu,215500,China)

机构地区：[1]江苏省常熟市第二人民医院胃肠外科,江苏常熟215500 [2]江苏省常熟市中医院普外科,江苏常熟215500

出　　处：《中国血液流变学杂志》2019年第3期316-318,333,共4页Chinese Journal of Hemorheology

摘　　要：目的研究腹腔镜辅助远端胃癌根治术对进展期胃癌的近期临床疗效分析.方法从2015年1月-2018年7月进展期胃癌患者中选取合适的研究对象95例,分为开腹组与腹腔镜组,回顾性分析近期临床疗效.结果腹腔镜组的手术时间、切口大小、手术过程中的出血量、肛门排气时间、可下床活动时间、手术后可进食时间分别为(180.60±15.07)min、(5.32±0.26)cm、(62.00±10.52)mL、(3.04±0.62)d、(2.90±0.69)d、(3.05±0.70)d,与开腹组比较差异均具有统计学意义(P<0.05).而术后的淋巴结清扫数、术后病理检查中肿瘤至远、近切缘距离分别是(31.65±8.80)个、(4.79±1.15)cm、(7.19±1.18)cm,与开腹组比较差异均无统计学意义(P>0.05).而开腹组切口感染和肺部感染的发生率则高于腹腔镜组(P<0.05),但是两组吻合口出血、吻合瘘及胃瘫的发生率差异无统计学意义(P>0.05).与开腹组相比,腹腔镜组在手术完成后的2 h、12 h及24 h的术后疼痛VAS评分较低,差异有统计学意义(P<0.05).结论腹腔镜手术切口小、出血少、恢复快,具有与开放远端胃癌D2根治术相似的根治性效果,且减少了患者的术后疼痛,有利于患者身体机能的恢复.Objective To explore the feasibility of laparoscopic-assisted D2 radical gastrectomy by comparing the short-term effect of advanced gastric cancer of open and laparoscopic-assisted surgery and their effect on cancer pain.Methods From January 2015 to July 2018,95 patients with advanced gastric cancer were selected and divided iuto laparoscopic group and open group.The short-term curative effect was analyzed retrospectively.Results The operative time,length of incision,bleeding volume,anal exhaust time,ambulation time,and diet intake time in the laparoscopic group were(180.60±15.07)min,(5.32±0.26)cm,(62.00±10.52)mL,(3.04±0.62)d,(2.90±0.69)d,(3.05±0.70)d,respectively,which were significantly different from those in the open group(P<0.05).The number of lymph node dissections and the length of subterminal and distal end to the cancer were(31.65±8.80),(4.79±1.15)cm and(7.19±1.18)cm,but there was no statistically significant difference between the two groups(P>0.05).The incidence of incision infection and lung infection in the open group was higher than that of the laparoscopic group(P<0.05).However,there was no statistically significant difference in the probability of bleeding and leakage of anastmotic stoma and gastroparalysis between the two groups(P>0.05).The VAS score of postoperative pain was lower in the laparoscopic group than that in the open group at 2 h,12 h and 24 h after operation.Conclusion Laparoscopy-assisted surgery has similar radical curative effect compared with open surgery.Moreover,it has the advantages of shorter incision,less bleeding,rapider recovery and less postoperative pain,which contribute to the recovery of patients with physical function,worthy of clinical promotion.

关 键 词：腹腔镜辅助手术 D2根治术 进展期胃癌 近期疗效 

分 类 号：R735.2[医药卫生—肿瘤] R730.56[医药卫生—临床医学]