腹腔镜辅助小切口胃癌根治手术治疗进展期胃癌的技术可行性和安全性分析

目的探讨腹腔镜辅助小切口胃癌根治手术治疗进展期胃癌的技术可行性和安全性。方法将2009年11月至2013年11月临邑县人民医院收治的60例进展期胃癌患者采用随机数字表法分为对照组与观察组,每组30例。对照组采用胃癌扩大根治性切除术,观察组采用腹腔镜辅助小切口胃癌根治术。比较两组临床疗效、手术前后免疫功能指标、Karnofsky评分、手术指标变化情况及术后不良反应发生率。结果 1观察组临床缓解率显著高于对照组(86.67%vs73.33%,P<0.05);2对照组术后IgG、IgM及IgA水平分别为(5.8±1.3)g/L、(0.8±0.2)g/L及(1.4±0.34)g/L,观察组术后分别为(7.7±1.4)g/L、(1.0±0.3)g/L及(2.4±0.6)g/L,观察组术后IgG、IgM及IgA水平均高于对照组,差异均有统计学意义(P<0.05)。结论腹腔镜辅助小切口胃癌根治手术治疗进展期胃癌技术可行,安全性较高,值得在临床上加以推广及普及。

Analysis of Technical Feasibility and Safety of Laparoscopic-assisted Small Incision Surgery for Advanced Gastric Cancer

Objective To investigate the technical feasibility and safety of small incision laparoscopic-assisted surgery for advanced gastric cancer.Methods A total of 60 patients with advanced gastric cancer,according to random number-table,were randomly divided into control group and observation group,30 cases each.The control group was treated with extended radical resection of gastric cancer,the observation group wastrested with small incision laparoscopic-assisted radical gastrectomy.The clinical efficacy,immune function before and after surgery,Karnofsky score,surgical index changes and the incidence of postoperative adverse reactions of the two groups were compared.Results ①Clinical remission rate of the observation troup was significantly higher than the control group（86.67％ vs 73.33％,P ＜ 0.05） ;② the IgG,IgM and IgA level of the control group after surgery were （5.8 ± 1.3） g/L,（0.8 ± 0.2） g/L and （1.4 ±0.34） g/L,respectively,of the observation group were （7.7 ±1.4） g/L,（1.0 ±0.3） g/L and （2.4 ± 0.6） g/L,the differences were statistically significant （P ＜ 0.05） ; Conclusion Laparoscopic-assisted small incision radical gastrectomy for advanced gastric cancer has good technical feasibility and high safety,thus is worthy of promotion in clinical practice.