摘要
目的:探讨腹腔镜全胃切除D2淋巴结清扫术治疗进展期胃癌的临床疗效。方法:回顾性分析2005年1月—2011年12月126例行全胃切除D2淋巴结清扫术治疗进展期胃癌患者资料,其中59例行腔镜手术(腔镜组),67行例行开腹手术(开腹组),比较两组的临床疗效。结果:两组手术时间、住院费用方面差异无统计学意义(均P>0.05),但腔镜组的胃肠功能恢复时间、进食时间、术后住院天数、术中出血量、切口长度方面均优于开腹组(均P<0.05)。两组术后总并发症发生率差异无统计学意义(P>0.05);腔镜组手术相关并发症发生率低于开腹组(P<0.05)。两组平均近、远切缘以及淋巴结清扫数目差异无统计学意义(均P>0.05);两组术后1、3、5年生存率和无瘤生存率间差异无统计学意义(均P>0.05)。结论:腹腔镜全胃切除D2淋巴结清扫术治疗进展期胃癌安全、有效。
Objective： To evaluate the clinical efficacy of laparoscopic total gastrectomy with D2 lymph node dissection in treatment of advanced gastric cancer. Methods： The clinical data of 126 patients with advanced gastric cancer undergoing total gastrectomy with D2 lymph node dissection from January 2005 to December 2011 were retrospectively analyzed. Of the patients, 59 cases received laparoscopic-assisted operation （laparoscopic group） while 67 cases were subjected to open surgery （laparotomy group）, and the clinical efficacies between the two groups were compared. Results. The difference in operative time and hospitalization expenses between the two groups had no statisticalsignificance （both P〉O.O5）, but the parameters that included time to bowel function recovery and food intake, length of postoperative hospital stay, intraoperative blood loss, and size of incision in laparoscopic group were superior to those in laparotomy group （all P〈O.05）. The overall incidence of postoperative complications between the two groups showed no statistical difference （P〉O.05）, but the incidence of surgery-related complications in laparoscopic group was lower than that in laparotomy group （P〈O.05）; the length of proximal or distal surgical margin, and number of resected lymph nodes of the two group were similar （all P〉O.05）, and the difference in 1-, 3-, 5-year overall survival or free tumor survival between the two groups showed no statistical significance（all P〉O.05）.Conclusion： Laparoscopic total gastrectomy with D2 lymph node dissection for advanced gastric cancer is safeand effective.
出处
《中国普通外科杂志》
CAS
CSCD
北大核心
2014年第4期412-416,共5页
China Journal of General Surgery
关键词
胃肿瘤
胃切除术
淋巴结切除术
腹腔镜
Stomach Neoplasms
Gastrectomy
Lymph Node Excision
Laparoscopes
