缩小根治术治疗早期胃癌的临床效果评价

目的考察缩小根治术与常规根治术治疗早期胃癌的临床效果。方法将90例接受手术治疗的早期胃癌患者随机分为两组,每组45例。常规全胃切除术组患者接受常规腹腔镜胃癌根治术,缩小根治术组患者接受腹腔镜缩小根治术。应用SPSS20.0软件包进行数据处理,手术时间、术中出血量肿瘤切缘、清扫淋巴结数量、术后进食时间、疼痛持续时间、肛门排气时间、住院时间等计量资料以(x珋±s)表示,采用t检验;并发症发生率等计数资料采用χ2检验。P0.05为差异具有统计学意义。结果缩小根治术组近端切缘为(3.5±1.4)cm、远端切缘为(2.5±0.9)cm显著低于常规全胃切除术组的(4.3±1.6)cm和(3.3±1.1)cm(t=2.524、3.776,P0.01);缩小根治术组淋巴结清扫数目(8.7±3.2)显著低于常规全胃切除术组的(14.5±4.6)(t=6.943,P0.01)。缩小根治术组患者术后进半流食时间为(5.2±1.9)d、肛门排气时间为(2.1±1.2)d显著低于常规全胃切除术组(7.1±2.1)d和(4.3±1.4)d(t=4.501、8.004,P0.01)以上差异均有统计学意义。两组患者手术时间、术中出血量、疼痛持续时间、住院时间、并发症发生率、随访期间患者复发率和病死率差异均无统计学意义(P0.05)。结论缩小根治术治疗早期胃癌手术安全有效,在保证手术效果的同时降低了患者的术中损伤,具有临床应用价值。

Decreased radical gastrectomy in treating early-staging gastric cancer

Objective To investigate the clinical outcome of decreased radical gastrectomy in treating early-staging gastric cancer .Methods A total of 90 patients with early gastric cancer were randomly divided into decreased radical gastrectomy group (45 patients) and routine radical gastrectomy group (45). SPSS 20.0 software package was employed for data analysis .The measurement data represented as mean ± SD included operation time, intraoperative bleeding, tumor margin, number of harvested lymph nodes, time for recovery liquid diet, pain time, anal exhaust time, hospital stay.They were examined using Student ’s t test.Count data such as complications incidence were examined using the Chi -square test.P<0.05 was considered statistically significant . Results The proximal and distal margins were (3.5 ±1.4) cm and (2.5 ±0.9) cm respectively in the decreased radical gastrectomy group , which were significantly less than (4.3 ±1.6) cm and (3.3 ±1.1) cm in the routine radical gastrectomy group (t=2.524, 3.776, P<0.01).The number of harvested lymph nodes in the decreased radical gastrectomy group was 8.7 ±3.2, which was significantly less than 14.5 ±4.6 in the routine radical gastrectomy group ( t =6.943, P <0.01).The time of recovery liquid diet and anorectum exhaust time were (5.2 ±1.9) d and (2.1 ±1.2) d respectively, which were all significantly less than (7.1 ±2.1) d and (4.3 ±1.4) d in the routine radical gastrectomy group (t=4.501, 8.004, P<0.01).There was no significant difference in complications rate between the two groups (P>0.05).There were no significant difference between the two groups in operation time, bleeding volume , pain duration , duration of hospitalization , complication rate and mortality ( P >0.05). Conclusion Decreased radical surgical treatment for early-staging gastric cancer is safe and effective with minimal invasion .