腹腔镜辅助下远端胃癌根治术与开放手术比较的临床研究

目的比较腹腔镜辅助下远端早、中期胃癌根治手术与传统开腹手术的疗效。方法回顾性分析我院2004年6月～2006年8月行腹腔镜辅助下根治性远端早、中期胃癌根治术19例及常规开腹远端早、中期胃癌根治术51例的临床资料。结果腹腔镜组19例均成功行腹腔镜辅助手术。腹腔镜手术和开放手术的平均时间分别为（194．5±23．21）min和（177．8±19．78）min，出血量分别为（182．4±40．21）ml和（346．8±33．98）ml，清扫淋巴结数量分别为（18．4±2．3）枚和（17．7±2．6）枚，术后肛门排气时间分别为第（4．31±1．28）d和第（4．89±1．62）d，平均住院时间分别为（14．3±2．5）d和（17．6±3．7）d，术后第1d平均白细胞计数分别为（8．79±3．54）×10^9／L和（10．43±2．78）×10^（／L。所有手术均无吻合口漏及术后死亡病例。结论腹腔镜辅助下胃癌根治术较传统开腹手术耗时长，但能达到胃癌标准根治术的淋巴结清扫范围，且具有出血少、住院时间短等优点。

Comparative study of laparoscopy-assisted distal gastrectomy vs open distal gastrectomy for gastric cancer

Objective To explore the operative outcome of resection of laparoseopy-assisted distal gastreetomy（LADG）vs open distal gastreetomy（ODG）for gastric cancer. Methods The data of medical records were retrospectively reviewed. There were 19 cases subject to LADG and 51 cases to ODG respectively. Results There was no conversion to laparotomy in the laparoseopie group. Mean operative time in LADG group and ODG group was（194. 5 ± 23.21）min and（177. 8 ± 19. 78）min,intraoperative blood loss （182.4 ± 40. 21 ）ml and （346. 8 ± 33.98）ml, mean retrieved lymph nodes （18. 4 ± 2.3） and（ 17. 7 ± 2. 6）, first flatus day（4. 31 ± 1.28） d and（4. 89 ± 1.62） d, mean hospital stay（ 14. 3 ± 2. 5）d and（17. 6 ± 3.7）d,and mean WBC number on the first postoperative day was（8.79 ± 3. 54）×10^9/L and（10. 43 ± 2. 78）×10^9/L respectively. There were no stomal leaks and postoperative deaths. Conclusion Although time consuming, LADG has several advantages compared with ODG, namely, LADG is safe with less blood loss and shorter hospital stay.