进展期胃癌腹腔镜辅助与开腹全胃D2根治术临床疗效的比较

发布时间：2018-07-05 14:28

  本文选题：胃癌 + 进展期　； 参考：《中国微创外科杂志》2017年07期

【摘要】：目的探讨腹腔镜辅助全胃D2根治术治疗进展期胃癌的应用价值。方法回顾性分析我科2012年2月~2015年7月83例进展期胃癌行全胃D2根治术的临床资料,其中腹腔镜辅助胃癌根治术40例(腔镜组),开腹胃癌根治术43例(开腹组)。比较2组围术期情况、术后病理和术后生存情况。结果腔镜组3例(7.5%)中转开腹。腔镜组手术时间明显长于开腹组[(266.0±36.3)min vs.(226.0±28.5)min,t=5.602,P=0.000],术中出血量明显少于开腹组[(156.2±55.7)ml vs.(261.6±87.2)ml,t=-6.609,P=0.000],术后肠功能恢复时间[(3.1±1.1)d vs.(3.7±1.5)d,t=-2.070,P=0.042]和住院时间[(14.5±3.9)d vs.(16.0±2.6)d,t=-2.135,P=0.036]明显短于开腹组。2组术中输血率差异无显著性[60.0%(24/40)vs.65.1%(28/43),χ~2=0.232,P=0.630]。2组术后并发症发生率差异无显著性[35.0%(14/40)vs.44.2%(19/43),χ~2=0.730,P=0.393]。2组所有病例均为R0切除,淋巴结清扫数目[(24.9±6.0)枚vs.(26.3±5.1)枚,t=-1.163,P=0.248]、淋巴结转移率[85.0%(34/40)vs.86.0%(37/43),χ~2=0.018,P=0.892]、阳性淋巴结数目[(5.8±3.7)枚vs.(6.2±3.1)枚,t=-0.452,P=0.653]、肿瘤TNM分期(χ~2=0.673,P=0.714)均无显著性差异。2组生存率无显著性差异(log-rank检验,χ~2=0.774,P=0.379)。结论与传统开腹手术相比,腹腔镜辅助全胃D2根治术治疗进展期胃癌安全可行,手术创伤小、术后恢复快,且胃周淋巴结清扫效果同开腹手术一致,术后总体生存率不低于开腹手术。
[Abstract]:Objective to evaluate the value of laparoscopic assisted D 2 radical gastrectomy in the treatment of advanced gastric cancer. Methods the clinical data of 83 patients with advanced gastric cancer undergoing total gastric D2 radical gastrectomy from February 2012 to July 2015 were retrospectively analyzed, including 40 cases of laparoscopic assisted radical gastrectomy (endoscopic group) and 43 cases of open radical gastrectomy (open group). The perioperative period, postoperative pathology and postoperative survival were compared between the two groups. Results 3 cases (7.5%) in the endoscopic group were converted to open operation. 鑵旈暅缁勬墜鏈�鏃堕棿鏄庢樉闀夸簬寮�鑵圭粍[(266.0卤36.3)min vs.(226.0卤28.5)min,t=5.602,P=0.000],鏈�涓�鍑鸿��閲忔槑鏄惧皯浜庡紑鑵圭粍[(156.2卤55.7)ml vs.(261.6卤87.2)ml,t=-6.609,P=0.000],鏈�鍚庤偁鍔熻兘鎭㈠�嶆椂闂碵(3.1卤1.1)d vs.(3.7卤1.5)d,t=-2.070,P=0.042]鍜屼綇闄㈡椂闂碵(14.5卤3.9)d vs.(16.0卤2.6)d,t=-2.135,P=0.036]鏄庢樉鐭�浜庡迹�

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