摘要
目的探讨开腹根治性全胃切除术与腹腔镜根治性全胃切除术治疗进展期胃癌的临床疗效。方法选取2015年4月-2018年4月我院收治的需行全胃切除术的胃癌患者98例为研究对象,按手术方案的不同分为对照组和观察组,每组49例。对照组行传统开腹根治性全胃切除术,观察组行传统腹腔镜根治性全胃切除术。对比2组患者术中情况、术后恢复和住院时间、淋巴结清扫、术后并发症发生情况。结果观察组的手术耗时明显多于对照组,肛门排气时间、住院时间均短于对照组(P<0.05);观察组手术切口长度和术中出血量小于对照组(P<0.05)。2组淋巴结清扫数量,近端和远端切缘与肿瘤的距离比较差异均无统计学意义(P>0.05)。观察组并发症发生率显著低于对照组(P<0.01)。结论腹腔镜根治性全胃切除术治疗进展期胃癌安全有效,并具有创口小、出血量少、住院时间短、术后恢复快、术后并发症发生概率低的特点。
Objective To investigate clinical efficacy of radical total gastrectomy by laparotomy and laparoscopic radical total gastrectomy in treatment of patients with advanced gastric cancer. Methods A total of 98 patients with gastric cancer admitted during April 2015 and April 2018, who needed to undergo total gastrectomy, were enrolled in the study, and the patients were divided into control group and observation group(n=49 in each group) according to surgical plans. Control group underwent traditional radical total gastrectomy by laparotomy, while observation group underwent laparoscopic radical total gastrectomy. Conditions of intraoperative situation, postoperative recovery, hospitalization time, lymph node dissection and postoperative complications were compared between two groups. Results In observation group, operative time was significantly longer, while time of anal exhaust and hospitalization time were significantly less(P<0.05), and length of surgical incision and volume of intraoperative blood loss were significantly less than those in control group(P<0.05). There were no significant differences in number of lymph node dissection between proximal and distance incisal edge with tumors in two groups(P>0.05). Incidence rate of complications in observation group was significantly lower than that in control group(P<0.01). Conclusion Laparoscopic radical total gastrectomy in treatment of patients with advanced gastric cancer is safer and more effective with smaller wounds, less bleeding volume, shorter hospitalization time, faster postoperative recovery and lower incidence rate of postoperative complications.
作者
李涛
刘立荣
谭玉成
王舒
LI Tao;LIU Li-rong;TAN Yu-cheng;WANG Shu(The First Department of General Surgery,General Hospital of Fuming,Liaoning Provincial Health Industry Group,Fushun,Liaoning 113008,China)
出处
《解放军医药杂志》
CAS
2019年第11期28-31,共4页
Medical & Pharmaceutical Journal of Chinese People’s Liberation Army
基金
辽宁省自然科学基金项目(201503104)
关键词
进展期胃癌
开腹根治性全胃切除术
腹腔镜根治性全胃切除术
治疗结果
Advanced gastric cancer
Radical total gastrectomy by laparotomy
Laparoscopic radical total gastrectomy
Treatment outcome
