腔镜下胃癌D2根治术治疗进展期远端胃癌的临床效果研究

目的 探讨腔镜下胃癌D2根治术治疗进展期远端胃癌的临床疗效。方法 按随机数字表法将本院于2016年1月—2018年12月接诊的96例进展期远端胃癌患者分为两组,各48例。对照组行常规开腹胃癌D2根治术,观察组行腹腔镜下胃癌D2根治术。对比两组围术期指标与术后并发症发生情况。结果 观察组手术操作时间(226.31±36.34)min、淋巴结清扫数量(12.97±4.01)个,与对照组相比(220.48±29.89,13.19±3.79),差异无统计学意义(P>0.05);治疗组术中失血量(114.49±20.27)mL、术后排气时间(3.18±0.42)d、切口长度(4.35±0.56)cm等其他手术指标均优于对照组(168.29±39.78,5.39±0.66,16.34±2.04),(P<0.05);对照组肺部感染、切口感染、吻合口出血、吻合口瘘等并发症总发生率(29.17%),高于观察组(12.50%,P<0.05)。结论 腹腔镜下胃癌D2根治术治疗进展期远端胃癌,可以达到开腹手术治疗效果,具有切口小、失血量少、术后恢复快等优势,更具安全性。

Clinical effect of laparoscopic gastric cancer D2 radical resection for advanced distal gastric cancer

Objective To evaluate the clinical efficacy of laparoscopic gastric cancer D2 radical resection in the treatment of advanced distal gastric cancer. Methods Ninety-six patients with advanced gastric cancer admitted to a hospital from January 2016 to December 2018 were divided into a trial group and a control group with 48 cases in each group. The control group underwent the conventional open gastric cancer D2 radical operation, and the trial group underwent the laparoscopic gastric cancer D2 radical resection. The perioperative indicators and postoperative complications were investigated and compared between two groups. Results The average operation time(226.31±36.34) min and the number of lymph node dissection(12.97±4.01) node in the treatment group were similar with those in the control group[(220.48±29.89) min and(13.19±3.79) node], and there were no statistically significant differences(P>0.05). Other surgical indexes, such as the average blood loss(114.49±20.27) mL, postoperative exhaust time(3.18±0.42) d, and incision length(4.35±0.56) cm of the trial group were superior to those of the control group [(168.29±39.78) mL,(5.39±0.66) min, and(16.34±2.04) cm](all P<0.05). The total incidence of complications, such as pulmonary infection, wound infection, anastomotic bleeding, anastomotic leakage, and other complications of the control group(29.17%) was higher than that of the trial group(12.50%), and the difference was statistically significant(P<0.05). Conclusion The laparoscopic gastric cancer D2 radical resection in the treatment of advanced distal gastric cancer has a similar therapeutic effect to the open surgery, and it has the advantages of small incision, less blood loss, quick recovery after surgery, and more safety.