腹腔镜辅助胃癌D2根治术治疗进展期胃癌的近期临床疗效观察

发布时间：2018-08-22 09:19

【摘要】：目的:通过对比腹腔镜辅助胃癌D2根治术与开腹手术的近期疗效,评估腹腔镜辅助胃癌D2根治手术在治疗进展期胃癌中的安全性、根治性及临床应用价值。方法:通过回顾性分析的方法,收集2014年10月至2016年11月期间在我院胃肠肿瘤外科行腹腔镜辅助及开腹胃癌D2根治术病人的临床资料,按照本次研究的的纳入及排除标准,筛选出腹腔镜40例、开腹组40例。研究的相关指标为:患者的性别、年龄、体重指数、肿瘤部位、手术切除范围及术后分期等可能影响本研究的一般资料;两组病人术中出血量、手术时间长度、淋巴结检出数等手术相关指标;两组病人术后通气时间、腹腔引流管拔出时间、术后住院日等术后恢复指标;术后并发症发生情况。通过对上述几组指标进行统计学分析,评估腹腔镜辅助胃癌D2根治手术治疗进展期胃癌的近期临床疗效。结果:两组病例在性别、年龄、BMI、肿瘤部位、手术方式、术后病理分期方面无统计学意义(P㧐0.05),具有可比性。腔镜组比开腹组术中出血少(P㩳0.05),有统计学差异。与开腹组相比,腹腔镜组术后通气快、拔管早、术后住院日短(P㩳0.05),此三项指标均有统计学差异。两组在手术时间相比,腹腔镜组手术时间明显较开腹组长(P㩳0.05),具有统计学意义。两组在淋巴结检出数、术后并发症方面无统计学差异(P㧐0.05)结论:腹腔镜辅助胃癌D2根治术和开腹胃癌手术相比,具有术中创伤小、出血少等优点,而且可达到与传统开腹手术相同的肿瘤根治程度。并且术后近期内通气快、住院日短,并发症发生率与开腹无异,是安全可行的。
[Abstract]:Objective: to evaluate the safety, efficacy and clinical value of laparoscopic assisted D2 radical gastrectomy for advanced gastric cancer. Methods: by retrospective analysis, the clinical data of patients undergoing laparoscopic assisted and open D2 radical gastrectomy for gastric cancer in our hospital from October 2014 to November 2016 were collected, according to the inclusion and exclusion criteria of this study. There were 40 cases of laparoscopy and 40 cases of open group. The related indexes of the study were: sex, age, body mass index, tumor location, surgical resection range and postoperative stages, etc., the amount of intraoperative bleeding, the length of operation time, and so on. The postoperative recovery indexes such as the number of lymph nodes detected, the time of postoperative ventilation, the time of pulling out the peritoneal drainage tube, the days of postoperative hospitalization, and the postoperative complications occurred in the two groups. To evaluate the short-term clinical effect of laparoscopic assisted D2 radical operation for advanced gastric cancer. Results: there was no significant difference between the two groups in sex, age, tumor location, operation mode and postoperative pathological stage (P0. 05). The operative bleeding in the endoscopic group was less than that in the laparotomy group (P < 0.05). Compared with the laparotomy group, the laparoscopic group had the advantages of quick ventilation, early extubation and short hospital stay (P0. 05). The operative time in the laparoscopy group was significantly longer than that in the open group (P0. 05). There was no significant difference in lymph node detection and postoperative complications between the two groups (P0. 05) conclusion: laparoscopic assisted D2 radical gastrectomy has the advantages of less trauma and less bleeding. And it can reach the same degree of radical resection as traditional open surgery. It is safe and feasible that the postoperative ventilation is quick, the hospital stay is short, the complication rate is the same as the open operation.
【学位授予单位】：青海大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R735.2

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