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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。
Objective To investigate the clinical effect of laparoscopic-assisted radical D2 distal root surgery in patients with advanced gastric cancer. Methods 92 patients with advanced gastric cancer who were treated in the Third People’s Hospital of Bengbu from January 2014 to December 2015 were divided into two groups. In the control group, 46 patients were treated with D2 radical resection of distal gastric cancer, and 46 patients in the observation group were given D2 laparoscopic distal gastric cancer. Perioperative conditions (operation time, intraoperative blood loss, incision length, postoperative ambulation time, hospital stay), the number of lymph nodes removed and postoperative complications were compared between the two groups after operation. SPSS 18.0 statistics Software 2 sets of data for statistical processing and analysis of the results. Results 2 patients completed the operation successfully. The operation time, intraoperative blood loss, incision length, postoperative ambulation time and hospital stay in the observation group were significantly less than those in the control group (P <0.05). The incidence of postoperative complications in the observation group was 2.1%, which was significantly lower than that in the control group (13.0%), the difference was statistically significant (P <0.05). The numbers of lymph nodes removed in the observation group and the control group were (25.4 ± 3.1) and (23.1 ± 4.3) pieces, respectively. There was no significant difference between the two groups (P> 0.05). Conclusions Laparoscopic-assisted D2 distal radical resection for advanced gastric cancer is better than D2 radical resection for distal gastric cancer, and has the advantages of less trauma, less bleeding, faster time to bed and fewer complications. Patients should be based on individual clinical treatment, select the appropriate treatment.