遵循相同原则的腹腔镜辅助与开腹胃癌根治手术的短期疗效比较  

Comparison of Short-term Efficacy between Laparoscopy and Open Surgery in Gastrectomy for Carcinoma of Stomach

作　　者：赵小军[1] 王元杰[1] 刘贵远[1] 程之逸[1] 徐宁[1] 毛旭南 黄传江[1] ZHAO Xiao-jun;WANG Yuan-jie;LIU Gui-yuan;CHENG Zhi-yi;XU Ning;MAO Xu-nan;HUANG Chuan-jiang(Taizhou People’s Hospital,Taizhou Jiangsu 225300,China)

机构地区：[1]泰州市人民医院胃肠外科,江苏泰州225300

出　　处：《泰州职业技术学院学报》2020年第1期120-124,151,共6页Journal of Taizhou Polytechnic College

摘　　要：目的比较腹腔镜辅助与开腹胃癌根治手术的短期疗效,评估腹腔镜辅助技术在胃癌手术中的应用。方法选取接受腹腔镜辅助胃癌根治术的131例患者作为腹腔镜组,另外选取同期接受开腹胃癌根治术的120例患者作为开腹组,比较两组患者的手术指标及短期疗效。结果腹腔镜组中进行全胃切除89例,近端胃切除例2例,远端胃切除40例;开腹组中进行全胃切除71例,近端胃切除14例,远端胃切除35例,在术中出血量(腹腔镜组40.15±8.46ml,开腹组100.56±24.86 ml)、术后肛门排气时间(腹腔镜组31.48±8.53h,开腹组46.39±12.56h)、疼痛(腹腔镜组中轻中重疼痛例数分别为75,51,5例,开腹组为8,55,57例)、住院时间(腹腔镜组10.53±5.16d,开腹组13.19±4.68d)及切口愈合不良(腹腔镜组2例,开腹组18例)项目中,腹腔镜组明显少于开腹组,在切口满意度(腹腔镜组中非常满意,基本满意,不太满意,很不满意的例数分别为32,83,14,2例,开腹组为11,64,30,15例)、手术时间(腹腔镜组162.25±40.26min,开腹组151.19±40.21min)、住院费用(腹腔镜组58914.39±1134.21元,开腹组52516.42±1245.79元)项目中,腹腔镜组明显高于开腹组,差异有统计学意义(P<0.05),两组在淋巴结清扫数目(腹腔镜组48.45±11.28枚,开腹组44.94±10.35枚)、肺部感染(腹腔镜组2例,开腹组7例)、腹腔感染(腹腔镜组2例,开腹组1例)、吻合口瘘(腹腔镜组1例,开腹组1例)、术后肠梗阻(腹腔镜组1例,开腹组4例)及非计划再次手术(开腹组观察0例,开腹组2例)方面差异无统计学意义(P>0.05)。结论腹腔镜辅助技术在胃癌根治术具有良好手术安全性及短期疗效。Objective To compare the short-term efficacy of laparoscopic assisted and open radical gastrectomy for gastric cancer,evaluate the application of laparoscopic assisted technique in radical gastrectomy.Methods Gastric cancer patients(n=251)undergoing radical gastrectomy at our institution from Jan.2017 to Dec.2018were en⁃rolled.131 underwent laparoscopic assisted group and 120 open radical gastrectomy,the operative indexes and short-term curative effect of the two groups were compared.Results Total gastrectomy was performed in 89 cases,proximal gastrectomy in 2 cases,and 40 cases underwent distal gastrectomy in the laparoscopic assisted group.In the open group,total gastrectomy was performed in 71 cases,proximal gastrectomy in 14 cases,and dis⁃tal gastrectomy in 35 cases.The difference between two groups about the intraoperative blood loss[(40.15±8.46)ml vs.(100.56±24.86)ml],bowel function recovery time[(31.48±8.53)h vs.(46.39±12.56)h],mean hospitaliza⁃tion[(10.53±5.16)d vs.(13.19±4.68)h],mean operation time[(162.25±40.26)min vs.(151.19±40.21)min],mean medical costs[(58914.39±1134.21)RMB vs.(52516.42±1245.79)RMB],postoperative pain,incision satis⁃faction and the incision poor healing were significant(P<0.05).Differences in the lymph node dissection,pul⁃monary infection,intra-abdominal infection,or anastomotic leakage between two groups were not significant(P>0.05).Conclusion Laparoscopic assisted radical gastrectomy is safe and feasible for gastric cancer,.

关 键 词：腹腔镜 胃切除术 胃癌 并发症 安全性 短期疗效 

分 类 号：R735.2[医药卫生—肿瘤]