老年进展期胃癌病人腹腔镜手术方式的近期疗效对比

目的分析老年进展期胃癌病人行全腹腔镜与腹腔镜辅助胃癌根治术的临床效果及安全性，为老年胃癌病人的手术治疗提供依据。方法选取54例老年进展期胃癌病人，随机数字法分为全腹腔镜胃癌根治术组24例和腹腔镜辅助胃癌根治术组30例，比较2组病人的术中出血量、淋巴结清扫数量、术后疼痛评分、术后排气时间、术后进食时间、术后住院时间、术后并发症发生率、术后C-反应蛋白、CD4/CD8及病人满意度。结果全腹腔镜组在术后疼痛评分、排气时间、术后住院时间较腹腔镜辅助组有统计学差异（P < 0.01），CRP在术后3 d、7 d明显低于腹腔镜辅助组（P < 0.01），CD4/CD8在术后1 d、7 d明显高于腹腔镜辅助组（P < 0.01和P < 0.05）；全腹腔镜组术后1 d明显高于术前（P < 0.01）。结论对于老年进展期胃癌病人，全腹腔镜胃癌根治术有较明显的近期疗效优势。

Comparison of short-term efficacy of laparoscopy therapy in elderly patients with advanced gastric cancer

ObjectiveTo analyze the clinical efficacy and safety of total laparoscopic radical gastrectomy and laparoscope-assisted radical gastrectomy in elderly patients with advanced gastric cancer, to provide reference for the surgical treatment of elderly patients with gastric cancer.MethodsA total of 54 elderly patients with advanced gastric cancer were selected and divided into total laparoscopic radical gastrectomy group (n=24) and laparoscope-assisted radical gastrectomy group (n=30) according to random number table method.The blood loss, number of lymph node dissection, postoperative pain score, exhaust time, eating time, hospitalization time, complication rate, C-reactive protein (CRP), CD4/CD8 and patient's satisfaction were compared between the two groups.ResultsThere were significant differences in postoperative pain score, exhaust time and hospitalization time between the two groups (P < 0.01).The level of CRP at 3 d and 7 d after operation in total laparoscopic radical gastrectomy group was significantly lower than that in laparoscope-assisted radical gastrectomy group (P < 0.01), and the level of CD4/CD8 at 1 d and 7 d after operation was higher than that in laparoscope-assisted radical gastrectomy group (P < 0.01 and P < 0.05), which at 1 d after operation was significantly higher than that before operation (P < 0.01).ConclusionsThe total laparoscopic radical gastrectomy has obvious advantages in short-term clinical efficacy for elderly patients with advanced gastric cancer.