腹腔镜辅助下远端胃癌D2根治术治疗进展期胃癌的疗效分析

目的 探讨腹腔镜辅助下远端胃癌D2根治术临床治疗进展期胃癌患者的效果。 方法 将2014年1月—2015年12月间在蚌埠市第三人民医院进行治疗的92例进展期胃癌患者，分为2组。对照组患者46例，临床给予开腹远端胃癌D2根治术治疗，观察组46例，临床给予腹腔镜辅助下远端胃癌D2根治术治疗。术后对2组患者围术期情况(手术时间、术中出血量、切口长度、术后下床活动时间、住院时间)、清除淋巴结数量、术后并发症情况进行统计，采用SPSS 18.0统计学软件对2组数据进行统计处理并对结果进行分析。 结果 2组患者均顺利完成手术。观察组手术时间、术中出血量、切口长度、术后下床活动时间、住院时间均明显小于对照组，差异有统计学意义(P＜0.05)。观察组术后并发症发生率为2.1%，明显小于对照组的13.0%，差异有统计学意义(P＜0.05)。观察组和对照组清除淋巴结数量分别为(25.4±3.1)枚和(23.1±4.3)枚，2组比较差异无统计学意义(P＞0.05)。 结论 腹腔镜辅助远端胃癌D2根治术治疗进展期胃癌相比于开腹远端胃癌D2根治术效果要好，且有创伤小、出血少、术后下床时间快、并发症小等优点。患者临床治疗时应依据个体情况，选择合适的治疗方法。 

Effect analysis of laparoscopic D2 radical distal gastrectomy for advanced gastric cancer

Objective To investigate the effect of laparoscopic D2 radical distal gastrectomy for advanced gastric cancer. Methods Total 92 patients with advanced gastric cancer in our hospital from January,2014 to December,2015 were randomly divided into two groups with random number method. Forty-six patients in the control group underwent open D2 radical distal gastrectomy,while 46 patients in the observation group underwent laparoscopic D2 radical distal gastrectomy.After the surgery,the perioperative conditions(operative time,blood loss,incision length,postoperative time to ambulation,hospital stay),postoperative complications and cleared lymph nodes number of the two groups were observed. The results of two groups were analyzed using SPSS18. 0. Results The operation time,blood loss,incision length,postoperative time to ambulation,hospital stay of the observation group were significantly less than those in the control group,the differences were statistically significant(P < 0. 05). The incidence of complication in the observation group was 2. 1%,significantly less than that in the control group(13. 0%),the difference was statistically significant(P < 0. 05). The cleared lymph nodes number of the two groups were 25. 4 ±3. 1 and 23. 1 ±4. 3,respectively,there was no significant difference in the cleared lymph nodes number between the two groups(P > 0. 05). Conclusion Compared with open D2 radical distal gastrectomy,laparoscopic open D2 radical distal gastrectomy can effectively treat advanced gastric cancer with advantage of less operation time,low blood loss,incision length,short postoperative time to ambulation and short hospital stay. The surgery method should be selected on the base of the individual circumstances.