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目的分析两种腹腔镜辅助胃癌根治术的临床应用效果。方法 2012年4月至2014年3月间收治的行腹腔镜胃癌根治术的胃癌患者50例,随机分为两组,分别实施腹腔镜下缝合重建的D2胃癌根治切除术(观察组)和腹腔镜辅助D2胃癌根治切除术(对照组)。结果 18例行腹腔镜下缝合重建的D2胃癌根治切除术,32例患者行腹腔镜辅助D2胃癌根治切除术,未出现中转开腹病例。观察组的手术时间显著长于对照组,差异有统计学意义(P<0.05)。两组的术中出血量和清扫淋巴结数目比较,差异均无统计学意义(均P>0.05)。观察组的术后镇痛时间和术后首次下床活动时间均显著短于对照组,差异均有统计学意义(均P<0.05);但两组的住院时间、术后住院时间、术后排气时间、并发症发生情况差异均无统计学意义(均P>0.05)。术后随访,两组患者均未见复发现象。结论与腹腔镜辅助D2胃癌根治切除术比较,腹腔镜下缝合重建的D2胃癌根治切除术具有可以接受的手术时间和并发症发生率。
Objective To analyze the clinical effects of two kinds of laparoscopic-assisted radical gastrectomy. Methods Fifty patients with gastric cancer who were undergone laparoscopic radical gastrectomy between April 2012 and March 2014 were randomly divided into two groups. The patients undergone D2 laparoscopic radical gastrectomy (observation group) and abdominal cavity Mirror assisted D2 radical resection of gastric cancer (control group). Results 18 cases underwent laparoscopic radical resection of D2 gastric cancer radical resection, 32 cases of laparoscopic-assisted D2 gastric cancer radical resection, did not appear the case of laparotomy. The operation time of the observation group was significantly longer than that of the control group, the difference was statistically significant (P <0.05). There was no significant difference between the two groups in the amount of bleeding and the number of lymph nodes (all P> 0.05). The analgesic time of the observation group and the time of first ambulation after the operation were significantly shorter than those of the control group (all P <0.05). However, the length of hospital stay, postoperative hospital stay, There was no significant difference in the time of exhausting and complications (all P> 0.05). After follow-up, no recurrence was observed in both groups. Conclusions Compared with laparoscopic-assisted radical gastrectomy for D2 gastric cancer, laparoscopic resection of D2 gastric cancer with radical gastrectomy has acceptable operation time and complication rates.