腹腔镜D2根治术联合淋巴结清扫治疗135例进展期胃癌患者的临床疗效及预后评估效果  

Clinical Efficacy and Prognostic Evaluation of Laparoscopic D2 Radical Resection Combined with Lymph Node Dissection in 135 Patients with Advanced Gastric Cancer

作　　者：冯鹏才 杨金煜[1] 唐明杰[1] 赵克昌[1] 田丰源 FENG Peng-cai;YANG Jin-yu;TANG Ming-jie;ZHAO Ke-chang;TIAN Fen-yuan(Department of General Surgery,Qinghai Provincial People's Hospital,Qinghai Xining 810000)

机构地区：[1]青海省人民医院普外科,青海西宁810000

出　　处：《中国医疗器械信息》2020年第21期93-95,共3页China Medical Device Information

摘　　要：目的:探讨腹腔镜D2根治术联合淋巴结清扫治疗进展期胃癌患者的临床疗效。方法:选择2016年6月~2018年6月本院收治的135例患者为观察对象,随机分为观察组(n=68)和对照组(n=67)。观察组给予腹腔镜D2根治术联合淋巴结清扫,对照组给予常规开腹D2根治术联合淋巴结清扫。观察比较两组临床疗效、手术时间、术中出血量、术后排气时间、住院时间、淋巴结清扫总数及并发症。结果:两组疗效整体比较差异明显(Z=-3.335,P=0.001);观察组有效率为91.18%和对照组85.07%比较,差异无统计学意义(χ^2=1.203,P=0.273)。观察组手术时间较对照组时间长(t=2.347,P=0.021),术中出血量、术后排气时间和住院时间则低于对照组(t=-8.273,P=0.000;t=-5.489,P=0.000;t=-4.686,P=0.000)。观察组和对照组淋巴结清扫总数、术后并发症发生率比较均无明显差别(t=0.312,P=0.758;χ^2=2.969,P=0.085)。结论:腹腔镜D2根治术联合淋巴结清扫治疗进展期胃癌的临床疗效及淋巴结清扫数量与开腹手术相当,可有效减少术中出血量,缩短术后排气时间及住院时间,安全性高。Objective:This study aims to investigate the clinical efficacy of laparoscopic D2 radical resection combined with lymph node dissection in the treatment of advanced gastric cancer.Methods:135 patients admitted to our hospital from June 2016 to June 2018 were randomly divided into observation group(n=68)and control group(n=67).The observation group were treated by laparoscopic D2 radical operation combined with lymph node dissection,while the control group were treated by routine open D2 radical operation combined with lymph node dissection.It observed and compared the clinical efficacy,operative time,intraoperative bleeding volume,postoperative exhaust time,hospital stay,total number of lymph node dissection and the complication between the two groups.Results:There was significant difference in overall efficacy between the two groups(Z=-3.335,P=0.001).The effective rate of 91.18%in the observation group,and that of 85.07%in the control group,which had no significant difference between the two groups(χ^2=1.203,P=0.273).The operation time of the observation group was longer than that of the control group(t=2.347,P=0.021).While,the amount of bleeding during operation,the time of exhaust after operation and the time of hospitalization were lower than those of the control group,respectively(t=-8.273,P=0.000;t=-5.489,P=0.000;t=-4.686,P=0.000).There was no significant difference in the total number of lymph node dissection and the incidence of complication between the two groups(t=0.312,P=0.758;χ^2=2.969,P=0.085).Conclusion:Laparoscopic D2 radical surgery combined with lymph node dissection for advanced gastric cancer has the same clinical efficacy and number of lymph node dissection as open surgery.It can effectively reduce intraoperative bleeding,shorten the time of exhaust after operation and hospitalization,and has high safety.

关 键 词：腹腔镜 D2根治术 淋巴结清扫 进展期胃癌 临床疗效 

分 类 号：TH779[机械工程—仪器科学与技术]