肥胖胃癌患者行腹腔镜与开腹根治性手术的疗效比较

目的探讨肥胖胃癌患者采用腹腔镜实施胃癌根治术的临床疗效。方法选取2009年12月至2012年11月间收治的152例肥胖胃癌患者，随机分为观察组和对照组，每组76例。观察组患者行腹腔镜胃癌根治术，对照组患者行开腹胃癌根治术，比较两组的疗效差异。结果观察组患者的手术时间为（224．8±52．8）min，出血量为（82．6±59．4）ml，排气时间为（3．4±1．2）d，住院时间为（15．3±8．9）d，发生感染1例（1．3％）。对照组患者的手术时间为（237．0±45．6）min，出血量为（251．7±246．3）ml，排气时间为（4．4±1．0）d，住院时间为（20．1±12．4）d，发生感染9例（11．8％）。两组比较，观察组手术时间更短，出血量更少，排气时间更早，住院时间更短，感染率更低。结论腹腔镜胃癌根治术对于肥胖胃癌患者具有更好的治疗效果，值得临床推广。

Comparison of curative effect of obesity of laparoscopic and open gastric cancer patients with radical operation

Objective To investigate the clinical curative effect of the obesity patients with gastric cancer by laparoscopic radical resection. Methods In our hospital from 2009 December to 2012 November were treated 152 cases of gastric cancer among obese patients as the research object, in accordance with the proportion of 1：1 were divided into observation group and control group, observation group underwent lapa- roscopic radical mastectomy for gastric cancer, the control group underwent open radical mastectomy for gastric cancer, to compare the clinical effect between the two groups. Results 76 patients with operation time of laparoscopic radical mastectomy for gastric cancer in the observation group was （224. 8 ± 52. 8） min, the amount of bleeding was （ 82. 6 ± 59. 4） ml, exhaust time was （3.4 ± 1.2 ） d, hospitalization time was （ 15.3 ± 8. 9）d, the number of infections 1, accounting for 1.3% ; and the implementation of operation time of 76 patients with gastric cancer radical surgery for open was （ 237.0 ± 45.6） min, the amount of bleeding was （251.7 ±246. 3）ml, exhaust time was（4. 4 ± 1.0）d, hospitalization time was （20. 1 ± 12.4）d, the number of infections 9, accounted for more than 11.8%. In comparison, laparoscopic radical mastectomy for gastric cancer with shorter operation time, less bleeding, exhaust time earlier, shorter hospital stay, and lower infection rate. Conclusions Laparoscopic radical mastectomy for gastric cancer patients with obesity has better curative effect, is worth the clinical promotion.