摘要
目的通过对腹腔镜下胃癌全胃切除术与开腹胃癌切除手术的比较分析,以评价其安全性、肿瘤根治性以及术后早期疗效。方法本组64例胃癌患者,其中29例行腹腔镜辅助下全胃切除术及35例行开腹全胃切除术,对两组病例的一般资料、ASA评分(美国麻醉师协会评分)、术前蛋白含量、胃癌分期、部位、及术后病理组织学类型及Bormann分型等指标进行比较分析。结果 29例胃癌患者成功接受腹腔镜辅助下全胃切除术。腹腔镜辅助下胃癌全胃根治术(D2)25例,腹腔镜辅助下姑息全胃切除术4例。术后两组患者均获得良好的早期临床效果。两组病例的手术时间平均为,腹腔镜组(241.78±45.43)min,开腹组(189.55±30.17)min(p<0.05)。与开腹组相比较,腹腔镜组的手术切口长度、术后肛门排气时间以及进食时间显著较低;术后腹腔镜组的白细胞及中性粒细胞计数均显著低于开腹手术组;两组病例的淋巴结清扫总数、第一及第二站淋巴结数比较均无统计学意义;比较手术切口感染率,腹腔镜组低于开腹组,而比较肺部感染率,腹腔镜组高于开腹组,但差异无统计学意义。结论腹腔镜胃癌全胃切除术是一种安全、微创的手术方法。腹腔镜胃癌全胃切除术与传统开腹胃癌全胃切除术可获得相同的淋巴结清扫范围及良好的早期疗效,但较开腹手术创伤小、术后恢复快优势。
Objective To compare the safety and clinical outcomes of 1 aparascopic total gastrectomy （LATG） with conventional open total gastrectomy （OTG） for treatment of gastric cancer. Methods There were 64 patients with gastric cancer, 29 patients were treated by LATG and 35 patients were treated by conventional open total gastrectomy. There were comparative excellence - good early recovery rates after operation in the two groups. General materials, BMI（ Body Mass Index）, the American Society of Anesthesiologists physical status classes, TP, AL, hemoglobin, whether or not receiving neoadjuvant chemotherapy and the UICC （1997） ＇s stage, site of tumor and the histologic type and Bormann type of pathology of two groups were compared. Results There were 29 patients in the LATG group, include 25 cases were performed LATG with D2 lymphadenectomy, and 4 cases accepted palliative total gastrectomy. There was significantly difference （p 〈 0. 05 ）between the mean operating time for laparoscopic surgery group （241.78 ± 45.43 ）minutes and open surgery group were （189.55 ± 30.17 ）minutes. In respect of the mean length of incision, the time to first flatus time, time to initiate oral intake, and postoperative hospital stay which in the laparoscopic surgery group was significantly lesser or shorter than those the open surgery group respectively. Comparing to that in open surgery group, postoperative value of leukocyte and granulocyte counts were significantly lower in laparoscopic surgery group. There was no significant difference between the two groups in respect of the number of harvested lymph nodes. Comparing the rate of infection of wound in the two groups, it was lesser in laparoscopic surgery group; but in respect of the rate of pulmonary infection, it was higher in the laparoscopic surgery group, and the difference was no significance. Conclusions LATG is a safe and minimally invasive surgical technique, which can lead to better post - operative recovery, and achieve the same cancer clearance as OTG.
出处
《现代医院》
2011年第7期30-32,共3页
Modern Hospitals
关键词
腹腔镜
胃癌
胃切除术
淋巴结清扫
Laparoscopy, Gastric cancer, Gastrectomy, Lymphadenectomy
