进展期胃癌腹腔镜辅助与开放D2根治术围手术期临床效果比较

目的:比较腹腔镜辅助与开放D2胃癌根治术手术、病理与术后恢复情况。方法:回顾性分析我科收治的202例胃癌患者。查阅电子病历系统，收集腹腔镜与开放胃癌根治术患者的病历资料，比较腹腔镜组和开放组手术时间、术中出血量、淋巴结清扫数目、术后并发症与术后恢复等相关指标。结果:与开放组相比，腹腔镜组术中出血量少［（90.63±78.66）vs (154.15±151.65)ml，P<0.001］，淋巴结清扫数目相当［(21.4±10.5) vs (21.7±11.4)个，P=0.810］，术后伤口脂肪液化发生少，术后通气时间早［（3.0±0.8）vs (3.5±1.0)天，P<0.001］，术后进半流食时间早［（6.2±1.5）vs （6.8±2.3）天，P=0.028］，术后住院时间短［（9.4±2.3）vs （11.3±3.0）天，P=0.022］，仅手术时间稍长［（222±36）vs（205±62）min，P=0.021］。结论:在进展期胃癌D2根治术中，虽然腹腔镜手术时间略长于开放组，总体而言，腹腔镜组能达到与开放手术相同的淋巴结清扫数目，且具有术中出血量少，术后恢复快的优势。

Comparison of the perioperative clinical results of laparoscopy -assisted and open radi-cal D2 gastrectomy in advanced gastric cancer

Objective:To compare the character of pathology,and postoperative between laparoscopic assisted D2 gastric cancer radical surgery and open D2 gastric cancer radical surgery for advanced gastric cancer.Methods:To choose 202 patients in our department from April 2014 to April 2015.Clinical dara of all 202 patients were studied retrospectively.The operation time,intraoperative blood loss,number of retrieved lymph node,time to first flatus,time to liquid diet,postoperative hospital stay,postoperative complications were compared between the two groups.Results:As compared with the open group,the bleeding amount of LAG group was significantly less(90.63 ±78.66)vs (154.15 ±151.65)ml,P <0.001 ],no significantly diffrence was found in the number of rerieved lymph node (21.4 ±10.5)vs (21.7 ±11.4),P =0.810],wound fat liquefaction was significantly less,the first flatus time was significantly shorter(3.0 ±0.8)vs (3.5 ±1.0)days,P <0.001],the first time to liquid diets was significantly shorter(6.2 ±1.5)vs (6.8 ±2.3)days,P =0.028],the postoperative hospitalization time was significantly shorter (9.4 ±2.3)vs (11.3 ±3.0)days,P =0.022],only longer surgical time was found(222 ±36)vs(205 ±62)min, P =0.021].Conclusion:In D2 radical prostatectomy of advanced gastric cancer,although the time of laparoscopic surgery is slightly longer than open group,laparoscopic group can achieve the same effect of retrieving the number of lymph node,and has obviously advantages of less intraoperative blood loss and postoperative complications,of course, faster recovery.