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目的探讨两种手术方式在老年胃癌患者中应用的可行性及临床疗效。方法回顾性分析作者医院2007-06/2009-03月收治的70岁以上行传统开腹手术的胃癌患者54例(传统开腹组),以及2010-06/2012-03月采用腹腔镜胃癌根治术的胃癌患者54例(腹腔镜组),比较2组患者近、远期疗效与并发症发生率。结果腹腔镜组术中出血量、切口长度、下床时间、胃管拔除时间、发热时间、进半流食时间、通气时间、术后住院时间、住院费用、术后发症发生率与传统开腹组比较差异存在统计学意义(P<0.05)。淋巴结清扫数目多于传统开腹组,同时手术时间延长,术后随访3年死亡率,组间比较差异均无统计学意义(P>0.05)。结论腹腔镜胃癌根治术安全、有效,近期疗效评价优于传统开腹手术,老年胃癌患者多合并心血管疾病,耐受性差,手术并发症多,可选择腹腔镜胃癌根治术。
Objective To investigate the feasibility and clinical efficacy of two surgical methods in elderly patients with gastric cancer. Methods A retrospective analysis was performed on 54 patients with gastric cancer who underwent conventional laparotomy over the age of 70 years in the hospital from 2007-06 / 2009-03. The patients in the traditional laparotomy group were treated with laparoscopic radical gastrectomy 54 cases of gastric cancer patients (laparoscopic group), the two groups of patients near and long-term efficacy and complication rates. Results The amount of bleeding, length of incision, bed-out time, gastric tube removal time, fever time, half-flow food time, ventilation time, postoperative hospital stay, hospitalization costs, There was significant difference between groups (P <0.05). The number of lymph node dissection was more than that of the traditional open group, meanwhile, the operation time was extended and the 3-year follow-up mortality was not statistically significant (P> 0.05). Conclusions Laparoscopic radical gastrectomy is safe and effective, and the short-term curative effect is superior to traditional laparotomy. There are many patients with advanced gastric cancer complicated with cardiovascular diseases. They are poorly tolerated and have many complications. Laparoscopic radical gastrectomy is an option.