腹腔镜辅助与开放性胃癌D2根治性全胃切除术临床分析

目的探讨腹腔镜辅助根治性全胃切除术（LATG）的可行性、安全性及治疗效果。方法回顾性分析本院2012年1月—2013年12月施行LATG（LATG组）和开放性辅助根治性全胃切除术（OTG组）患者的临床病理资料，比较2组手术安全性、术后恢复及肿瘤根治性。结果共274例患者纳入本研究，其中LATG组109例，OTG组165例。LATG组手术时间[（187．9±37．6）min]明显延长（P〈0．001），但术中出血量[（166．5±59．3）mL]较OTG组[（309．4±93．1）mL]少（P〈0．001），术后排气时间（P〈0．001）、进食时间（P〈0．001）、住院时间（P〈0．001）、白细胞计数（P〈0．05）以及引流量（P〈0．05）等方面，LATG组均较OTG组有优势。结论腹腔镜辅助根治性全胃切除术安全可行，具有切口小、术后恢复快等优点。

Analysis in clinical efficacy of laparoscopy-assisted open D2 radical total gastrectomy

Objective To explore the feasibility, safety and efficacy of laparoscopy-assisted radical total gastrectomy（LATG）. Methods Clinical materials of LATG patients and open total gas- trectomy （OTG） patients were analyzed retrospectively. Feasibility, safety and short-term outcomes were compared between two groups. Results 274 patients were collected, and there were 109 cases in the LATG group and 165 cases in the OTG group. Operation time in the TLTG group [ （ 187.9 ± 37.6） minutes] was significantly longer than that in the OTG group （P 〈 0.001 ）, while the intraoperative blood loss was significantly lower than the LATG group [ （ 16 6.5 ±5 9.3 ） mL ： （ 3 0 9.4 ± 93.1 ） mL] （P 〈0. 001 ）. First flatus time （P 〈0. 001 ）, first diet time （P 〈0.001 ）, post operative hospital stay （P 〈0.001 ）, white blood cells counting （P 〈 0.05 ）, and drainage （P 〈 0.05 ） in the LATG group were significantly lower than those in the OTG group. Conclusion LATG is a safe and feasible procedure for the treatment of gastric cancer, and it has advantages such as high security, small trauma and quick post-operative recovery.