摘要
目的探讨腹腔镜辅助根治性全胃切除术的可行性及临床疗效。方法回顾性分析2006年3月至2010年9月行腹腔镜辅助根治性全胃切除术(腹腔镜组)106例及同期开腹根治性全胃切除术(开腹组)247例患者的临床资料。比较两组的淋巴结清扫数目及患者术中情况、术后恢复、手术并发症等指标。结果腹腔镜组清扫淋巴结数为(28.77±12.75)枚,与开腹组清扫淋巴结数(27.07±11.51)枚相比,差异无显著统计学意义(P=0.269)。腹腔镜组平均手术时间为(220.7±40.4)min,长于开腹组(178.5±29.1)min,两组差异有统计学意义(P<0.05)。术中失血量:腹腔镜组与开腹组分别为(232.1±132.1)ml、(296.9±135.6)ml,差异有统计学意义(P<0.05)。腹腔镜组术后肛门排气时间为(3.6±1.0)d,显著早于开腹组(4.3±0.8)d,手术并发症发生率方面,腹腔镜组与开腹组分别为17.9%、20.4%,相比差异无统计学意义(P>0.05)。结论腹腔镜辅助根治性全胃切除术具有切口小、术后恢复快等微创优势,技术上是安全可行的,清扫淋巴结数目和开腹手术相当,符合肿瘤根治原则,近期疗效肯定。
Objective To explore the feasibility and clinical outcome of laparoscopy-assisted radical total gastrectomy with D2 dissection and comparing the differences between the laparoscopic group and the open group.Methods Retrospective reviewed the clinical data of 106 cases who were treated with laparoscopic total gastrectomy from March 2006 to September 2010.Comparing with the same period 247 cases of open total gastrectomy with D2 dissection.The lymph node dissection amount,blood loss,operation time and postoperative recovery and complications of two groups were analysed.Results No significant difference was found in the amount of resected lymph node between these two groups respectively.The average operation time of the 1aparoscopy-assisted group was significant longer than the open group.About the mean volume of blood loss,1aparoscopy-assisted group and the open was（232.1 ± 132.1） ml vs.（296.9 ± 135.6） ml,there were significant differences between the two groups,and there were also significant differences in the time of return to bowel function,the 1aparoscopy-assisted group was shorter than open group.About postoperation complication,no significant difference between them.Conclusions The 1aparoscopy-assisted total gastrectomy with D2 lymphadenectomy for gastric cancer is feasible and safe.It is no difference in amount of resected lymph nodes between 1aparoscopic and open gastrectomy and it can satisfy oncologic criteria.Laparoscopic total gastrectomy has the advantage of much safer,and the faster postoperative recovery compare with the open surgery.The short-term outcome has been confirmed.
出处
《中华腔镜外科杂志（电子版）》
2012年第2期7-10,共4页
Chinese Journal of Laparoscopic Surgery(Electronic Edition)
基金
福建省医学创新课题(2007-CXB-2)
关键词
腹腔镜
淋巴结清扫
胃肿瘤
全胃切除术
Laparoscope
Lymphadenectomy
Gastric cancer
Total gastrectomy
