摘要
目的探讨比较胃癌在腹腔镜手术与开腹手术中的疗效。方法采用回顾性队列研究方法。整理了2011年1月—2017年4月该院收治的83例胃癌患者,其中腹腔镜组43例,开腹组40例。腹腔镜组平均年龄:﹙62.5±11.3﹚岁,开腹组平均年龄:(60.3±9.2)岁,观察指标:①临床资料;②术中术后情况:手术时间,术中出血量,淋巴结清扫数目,术后首次排气时间,术后首次进食时间,术后首次下床活动时间,术后住院时间,术后1年生存,术后2年生存;③术后并发症:切口感染,肺部感染,腹腔感染,腹腔出血,吻合口瘘,十二指肠残端瘘,胃瘫。结果①临床资料比较:二者在性别、年龄、BMI、肿瘤部位、肿瘤分期方面,均差异无统计学意义(P>0.05)。②术中术后情况:术中出血量(135±65)mL、术后首次排气时间(2.7±1.1)d、术后首次进食时间(4.3±1.1)d、术后首次下床活动时间(2.4±0.5)d、术后住院时间(11.1±2.7)d腹腔镜组指标均优于开腹组,差异有统计学意义(t=2.970,2.088,2.155,2.829,0.194,P=0.004,0.040,0.034,0.006,0.659)。手术时间腹腔镜组(232.5±41.2)min长于开腹组(180.4±40.1)min,差异有统计学意义(t=5.831,P=0.000),术后1年、2年生存时间差异无统计学意义(P>0.05)。③术后并发症:二者术后并发症(切口感染,肺部感染,腹腔感染,腹腔出血,吻合口瘘,十二指肠残端瘘,胃瘫)总数比较差异无统计学意义(P>0.05)。结论通过临床对比研究,腹腔镜手术治疗胃癌相对于开腹手术治疗胃癌,虽然手术时间长于开腹组,但具有术中出血少、淋巴结清扫数目多、术后胃肠功能恢复快、早期进食、下床活动、住院时间短等优点,同时在术后1年、2年生存期及术后并发症方面无统计学差别,是损伤小,恢复快,安全可靠的术式,可以在临床推广发展。
Objective To investigate the efficacy of gastric cancer in laparoscopic surgery and open surgery.Methods A retrospective cohort study approach was used.83 patients with gastric cancer admitted to our department from January 2011 to April 2017 were enrolled,including 43 in the laparoscopic group and 40 in the open group.The average age of the laparoscopic group was(62.5±11.3)years,and the average age of the open group was(60.3±9.2)years.Observed indicators:1.clinical data;2.intraoperative and postoperative conditions:operation time,intraoperative blood loss,lymph node dissection number,first postoperative exhaust time,first postoperative feeding time,first time to get out of bed after surgery,postoperative hospital stay,1 year postoperative survival,2 years postoperative survival;3.postoperative complications:incision infection,pulmonary infection,abdominal infection,abdominal bleeding,anastomotic leakage,duodenal stump fistula,stomach cramps.Results 1.Comparison of clinical data:There was no significant difference in gender,age,BMI,tumor location and tumor stage(P>0.05).2.Intraoperative and postoperative conditions:intraoperative blood loss(135±65)mL,first exhaust time after surgery(2.7±1.1)d,first time after surgery(4.3±1.1)d,first time after going to bed time(2.4±0.5)d and postoperative hospital stay(11.1±2.7)d were better than the open group in the laparoscopic group,the difference was statistically significant(t=2.970,2.088,2.155,2.812,P=0.004,0.040,0.034,0.006).The laparoscopic group(232.5±41.2)min was longer than the open group(180.4±40.1)min,and there was a statistical difference(t=5.831,P=0.000).There was no significant difference in 1-year and 2-year survival time after surgery(P>0.05).3.Postoperative complications:there was no statistically significant difference in the total number of postoperative complications incision infection,pulmonary infection,abdominal infection,abdominal hemorrhage,anastomotic leakage,duodenal stump fistula,stomach cramps(P>0.05).Conclusion Through clinical comparativ
作者
林明
LIN Ming(Department of General Surgery,Section Two,Sanming City Hospital of Integrated Traditional Chinese and Western Medicine,Sanming,Fujian Province,365001 China)
出处
《中外医疗》
2019年第34期15-18,共4页
China & Foreign Medical Treatment
关键词
胃癌
腹腔镜
开腹
疗效
Gastric cancer
Laparoscopy
Laparotomy
Curative effect
