腹腔镜辅助与开腹胃癌根治术的短期临床效果比较

发布时间：2018-11-27 19:00

【摘要】：目的比较腹腔镜辅助胃癌根治术与开腹胃癌根治术的短期临床效果。方法选取2014年1—12月于本院普通外科住院并诊断为胃癌的患者185例,男105例,女80例,年龄31~85(55±6)岁,其中腹腔镜辅助胃癌根治术86例(腹腔镜组),开腹胃癌根治术99例(开腹组),两组资料具有可比性(P0.05);比较两组短期临床效果。结果与开腹组相比,腔镜组手术切口直径短[(5.8±0.5)cm vs(14.1±1.3)cm,P0.05],手术时间长[(190.9±50.3)min vs(150.7±43.1)min,P0.05],术中出血量少[(107.3±70.3)ml vs(158.3±90.8)ml,P0.05],术后排气时间短[(3.0±0.4)d vs(3.9±0.5)d,P0.05],进食时间早[(3.7±0.9)d vs(4.3±0.7)d,P0.05],住院时间短[(9.6±3.4)d vs(12.2±6.9)d,P0.05],差异均有统计学意义(P0.05)。两组的手术切除淋巴结数目[(26.4±7.5)vs(27.2±7.7),P0.05]、淋巴结阳性数[(3.0±1.0)vs(3.0±0.9),P0.05)]、切缘阳性率(1.16%vs 1.01%)和术后并发症发生率(4.6%vs 5.0%)差异均无统计学意义(P0.05)。结论传统开腹胃癌根治手术能够彻底切除病灶,但切口大、手术出血量大,术后恢复慢。而腹腔镜辅助胃癌根治术手术创伤小,术后患者恢复快,可获得较好短期临床效果,优势明显,但手术时间稍长。
[Abstract]:Objective to compare the short-term clinical effects of laparoscopic assisted radical gastrectomy and open radical gastrectomy. Methods from January to December 2014, 185 patients (105 males and 80 females, aged 31 ~ 85 (55 卤6) years) who were hospitalized in general surgery and diagnosed as gastric cancer in our hospital from January to December 2014 were selected. Among them, 86 cases were treated with laparoscopic assisted radical gastrectomy (Laparoscopic group). There were 99 cases of radical gastrectomy (open group). The data of the two groups were comparable (P0.05). To compare the short-term clinical effect between the two groups. Results compared with the open group, the operative incision diameter was shorter in the endoscopic group [(5.8 卤0.5) cm vs (14.1 卤1.3) cm,P0.05], and the operative time was longer [(190.9 卤50.3) min vs () 150.7 卤43.1 min,P0.05]. The blood loss was less during operation [(107.3 卤70.3) ml vs () 158.3 卤90.8 ml,P0.05], and the postoperative exhaust time was shorter [(3.0 卤0.4) d vs (3.9 卤0.5) d (P0.05)]. The feeding time was early [(3.7 卤0.9) d vs (4.3 卤0.7) dU P0.05], the hospitalization time was short [(9.6 卤3.4) d vs (12.2 卤6.9) dP05], the difference was statistically significant (P0.05). The number of lymph nodes resected in both groups [(26.4 卤7.5) vs (27.2 卤7.7), P0.05], the number of positive lymph nodes [(3.0 卤1.0) vs (3.0 卤0.9), P0.05], The positive rate of incision margin (1.16%vs 1.01%) and the incidence of postoperative complications (4.6%vs 5.0%) had no significant difference (P0.05). Conclusion the traditional radical operation for gastric cancer can completely remove the lesions, but the incision is large, the amount of bleeding is large, and the recovery is slow. Laparoscopy-assisted radical gastrectomy has less trauma, faster recovery, and better short-term clinical effect, but the operation time is longer than that of laparoscopically assisted radical gastrectomy.
【作者单位】：解放军总医院普通外科;
【基金】：国家自然科学基金项目(61170123)~~
【分类号】：R735.2

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