腹腔镜辅助远端胃癌D2根治术的疗效及安全性探讨

发布时间：2018-06-22 23:03

本文选题：胃癌 + 远端　；参考：《疑难病杂志》2017年12期

【摘要】：目的探讨腹腔镜辅助远端胃癌D2根治术的疗效及安全性。方法选择2009年1月—2011年12月在海南医学院第二附属医院肿瘤外科行远端胃癌D2根治术的患者184例,按照手术方式的不同分为传统开腹组与腹腔镜组,传统开腹组83例,腹腔镜组101例,传统开腹组患者采用传统开腹行远端胃癌D2根治术,腹腔镜组患者使用腹腔镜辅助远端胃癌D2根治术,对术中、术后相关指标,术后生活质量(karnofsky)评分及生存时间进行对比。结果腹腔镜组患者的手术时间长于传统开腹组,手术切口长度、手术失血量少于传统开腹组(t=8.354、46.236、54.467,P0.01),2组清扫淋巴结数量、近切端距肿瘤距离和远切端距肿瘤距离比较差异无统计学意义(t=1.685、1.467、0.397,P0.05);腹腔镜组患者术后排气时间、下床活动时间、镇痛药使用次数、流食进食时间和住院时间等均短/少于传统开腹组,差异具有统计学意义(t=16.171,12.508,15.521,9.657,12.239,P0.01);2组患者的各项并发症、生存时间差异均不具有统计学意义(P均0.05);腹腔镜组患者在手术后5 d的Karnofsky评分高于传统开腹组,差异具有统计学意义(t=6.906,P0.05),术后30 d的Karnofsky评分比较差异无统计学意义(t=0.725,P0.05)。结论利用腹腔镜辅助进行远端进展期胃癌D2根治术,与开腹手术的近期效果及远期效果大体相当,但是利用腹腔镜进行操作,对患者造成的创伤较小,患者恢复速度快,安全性较好。
[Abstract]:Objective to evaluate the efficacy and safety of laparoscopic assisted D 2 radical resection of distal gastric cancer. Methods 184 patients with distal gastric cancer undergoing D2 radical gastrectomy were selected from January 2009 to December 2011 in the second affiliated Hospital of Hainan Medical College. According to the different operation methods, 184 patients were divided into traditional open group and laparoscopic group, 83 cases in traditional open group. There were 101 cases in the laparoscopic group. The patients in the traditional laparotomy group were treated with the traditional operation of D _ 2 radical gastrectomy of distal gastric cancer, and the patients in the laparoscopic group were treated with laparoscopic assisted D _ 2 radical resection of distal gastric cancer. Quality of life (QOL) (karnofsky) score and survival time were compared. Results the operative time of the patients in the laparoscopic group was longer than that in the traditional open group. The length of the incision and the amount of blood loss in the operation were less than those in the traditional group (t = 8.354 46.236 ~ 54.467 / P0.01), and the number of lymph nodes dissected in the two groups was less than that in the conventional laparotomy group. There was no significant difference between the distance from the proximal end to the tumor and the distance from the distal end to the tumor (P 0.05). The feeding time and hospitalization time were shorter / shorter than those in the traditional open group, and the difference was statistically significant (t = 16.171 ~ 12.508 ~ 15.521 ~ 9.657 / 12.239 / P0.01). There was no significant difference in survival time (P 0.05), and the Karnofsky score in laparoscopic group was significantly higher than that in traditional laparotomy group at 5 days after operation (t = 6.906 P 0.05), but there was no significant difference in Karnofsky score at 30 days after operation (t = 0.725 P 0.05). Conclusion Laparoscopic assisted D2 radical resection of distal advanced gastric cancer is similar to that of open surgery in the near and long term. The safety is good.
【作者单位】：海南医学院第二附属医院肿瘤外科;
【分类号】：R735.2

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