腹腔镜与开腹手术治疗胃癌的临床疗效比较

目的比较腹腔镜与开腹手术治疗胃癌的临床疗效,探讨腹腔镜胃癌根治术的临床价值。方法回顾性分析2007年1月至2010年12月收治的103例胃癌患者,其中采用腹腔镜胃癌根治术(LAP组)治疗49例,采用传统开腹胃癌根治术(OPEN组)54例,比较两组的手术时间、手术切口程度、术中出血量、术后胃肠道恢复时间、清扫淋巴结数、术后住院天数、术后并发症等指标。结果 LA组的术中出血量、胃肠道恢复时间和住院天数都明显少于OPEN组,无瘤生存率也均优于OPEN组,但其手术时间较长(P<0.05),两组在局部复发、远处转移和并发症发生率方面差异有统计学意义(P>0.05)。术后1周,LAP组外周血T淋巴细胞亚群CD3+、CD4+、CD8+、CD4+/CD8+及NK细胞活性均高于OPEN组,差异有统计学意义(P<0.05)。结论腹腔镜胃癌根治术安全可靠,具有创伤小、出血少、术后恢复快等优点,值得临床使用。

Comparison of clinical curative effect of laparoscopic gastrectomy and open gastrectomy for gastric cancer

Objective To compare the therapeutic effects between laparoscopic gastrectomy and open gastrectomy for gastric cancer.Methods A retrospective analysis of 103 cases of patients with gastric cancer from January 2007 to December 2010 was made;the patients were divided into observation group(including 49 patients received laparoscopic gastrectomy) and control group(including 54 patients received conventional open gastrectomy).The operative time,intraoperative blood loss,postoperative gastrointestinal recovery time,postoperative hospital stay,and postoperative complications were observed and compared between the two groups.Results The intraoperative blood loss,postoperative gastrointestinal recovery time,and postoperative hospital stay were shorter,and the disease-free survival rate was superior in observation group than those of control group;but the operative time of observation group was longer than that of control group(P<0.05).In addition,there was no statistically significant difference in local recurrence,distant metastasis and complication rate between the two groups.A week later,T lymphocyte subsets and NK cells of the former were better than those in the control group(P<0.05).Conclusion The laparoscopic gastrectomy is safe and reliable in the treatment of gastric cancer with certain quick postoperative recovery,and is worth clinical use.