腹腔镜辅助D2根治性全胃切除术与传统开腹手术治疗胃癌的近期疗效及血清学变化比较

目的 探讨腹腔镜辅助D2根治性全胃切除术与传统开腹手术治疗胃癌的近期疗效及血清学变化.方法 选取118例胃癌患者,依照患者意愿和手术需求分为腹腔镜组(n=59)和开腹组(n=59).腹腔镜组行腹腔镜辅助D2根治性全胃切除术,开腹组行传统开腹全胃切除术,比较两组患者的术中、术后指标及血清学变化.结果 腹腔镜组患者的手术时间长于开腹组,术中出血量少于开腹组,切口长度短于开腹组,差异均有统计学意义(P﹤0.05);两组患者的淋巴结清扫数目比较,差异无统计学意义(P﹥0.05).腹腔镜组患者术后肛门排气时间、开始进食流质时间、开始进食半流质时间和住院时间均短于开腹组,差异有统计学意义(P﹤0.05).术后72 h,两组患者的肝肾功能指标ALT、AST、ALB、BUN及炎症相关指标WBC、NE、CRP比较,差异均无统计学意义(P﹥0.05),但腹腔镜组患者的Cr水平高于开腹组,差异有统计学意义(P﹤0.05).结论 腹腔镜辅助D2根治性全胃切除术治疗胃癌不仅安全有效,而且创伤小,术后患者恢复快,值得临床推广应用.

A comparison study of short-term outcomes and the serological changes between laparoscopic-assisted D2 radical total gastrectomy and traditional open gastrectomy for gastric cancer

Objective To compare the short-term outcomes and the serological changes in gastric cancer patients re-ceiving laparoscopic-assisted D2 radical total gastrectomy and traditional open gastrectomy. Method A total of 118 cas-es who were diagnosed as gastric cancer were included in the study, laparoscopic-assisted D2 radical total gastrectomy (laparoscopic surgery group, n=59) or traditional open gastrectomy (open surgery group, n=59) were administered as per patients'intention and respective surgery strategy, the intra-operative and post-operative measures, as well as serological changes in both groups were compared. Result The operative time was shorter, intra-operative blood loss was less, and incision length was trimmed in laparoscopic surgery group compared with open surgery group (P<0.05);both groups had similar number of resected lymph nodes (P>0.05); patients receiving laparoscopic surgery were observed with shorter time to first flatus, time to eat liquid and semi-liquid food, and decreased hospital stay compared with those underwent open surgery (P<0.05);in 72 h after surgery, there was no significant differences between the two groups in regard of liv-er and kidney function indexes of ALT, AST, ALB, BUN and inflammation related indexes such as WBC, NE, and CRP (P>0.05), but the Cr level of laparoscopic surgery group was higher than that of the open surgery group, the difference was statistically significant (P<0.05). Conclusion Laparoscopic-assisted D2 radical total gastrectomy is a safe and effec-tive procedure in treating gastric cancer, with minimal invasiveness and enhanced post-operative recovery, and is worth clinical application.