Journal of Qiqihar University of Medicine最新文献

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Comparative study of laparoscopic gastrectomy D2 radical surgery and open gastrectomy for upper stomach cancer 腹腔镜胃切除术D2根治术与开放式胃切除术治疗上胃癌的比较研究

Journal of Qiqihar University of Medicine

Pub Date : 2013-01-01 DOI: 10.3760/CMA.J.ISSN.1006-9801.2014.05.012

Wenlin Lin, Zhixiong Li, Yanchang Xu, Xuyun Xie, Zhiqing Huang, Guofeng Pan

Objective To evaluate the safety,tumor radical and early postoperative efficacy through comparison of laparoscopic gastric D2 radical surgery with traditional open gastric D2 radical surgery.Methods 254 patients with upper stomach cancer underwent surgery were selected,132 cases using conventional open gastrectomy (the traditional laparotomy group),122 patients underwent laparoscopic radical gastrectomy (laparoscopic surgery group).Laparoscopic surgery group with traditional open surgery group had no statistically significant differences in gender,age,tumor location,histological type and TNM staging.Results Open surgery group and laparoscopic surgery group had statistically significant differences in operative time [(235.78±31.56) min,(256.43±54.08) min,P ＜ 0.001],blood loss [(326.69±89.73) ml,(158.31±62.98) ml,P ＜ 0.001],incision length [(16.53±2.34) cm,(5.51±1.15) cm,P ＜ 0.001],gastrointestinal recovery time [(4.22±0.91) d,(3.31±0.83) d,P ＜ 0.001],first time eating liquid [(5.78±0.95) d,(5.56±0.78) d,P ＜ 0.001] and postoperative hospital stay [(12.62±2.89) d,(11.18±1.78) d,P ＜ 0.001].The total number of lymph node dissection and complications was not statistically significant.Conclusions Laparoscopic gastric D2 radical surgery is a safe,minimally invasive surgical method.Laparoscopic gastric D2 radical surgery has the same lymph node dissection and good early outcome compared with the traditional gastric D2 radical surgery,but postoperative recovery fast and less invasive. Key words: Gastric neoplasms; Gastric cancer radical operation; Laparoscopic; Rubber band fixed law

目的比较腹腔镜胃D2根治术与传统开放胃D2根治术的安全性、肿瘤根治性及术后早期疗效。方法选取经手术治疗的上胃癌患者254例，其中常规开胃切除术132例(传统开腹组)，腹腔镜根治性胃癌122例(腹腔镜手术组)。腹腔镜手术组与传统开放手术组在性别、年龄、肿瘤位置、组织学类型、TNM分期等方面差异均无统计学意义。结果开放手术组与腹腔镜手术组在手术时间[(235.78±31.56)min，(256.43±54.08)min,P < 0.001]、出血量[(326.69±89.73)ml，(158.31±62.98)ml,P < 0.001]、切口长度[(16.53±2.34)cm，(5.51±1.15)cm,P < 0.001]、胃肠恢复时间[(4.22±0.91)d，(3.31±0.83)d,P < 0.001]、首次流食时间[(5.78±0.95)d，(5.56±0.78)d,P < 0.001]、术后住院时间[(12.62±2.89)d，(11.18±1.78)d,P < 0.001]、差异均有统计学意义。两组淋巴结清扫及并发症总数比较，差异无统计学意义。结论腹腔镜胃D2根治术是一种安全、微创的手术方法。腹腔镜胃D2根治术与传统胃D2根治术相比，具有相同的淋巴结清扫和良好的早期预后，但术后恢复快，创伤小。关键词:胃肿瘤;胃癌根治术;腹腔镜;橡皮筋固定律

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