论文部分内容阅读
目的分析腹腔镜全胃D2根治术与开腹手术治疗胃上部癌的临床效果及安全性。方法 104例胃上部癌患者随机分为研究组与对照组,每组52例,研究组行腹腔镜全胃D2根治术治疗,对照组采取开腹手术治疗,比较两组患者手术指标(手术时间、出血量、切口长度)以及康复指标(胃肠功能恢复时间、首次进食时间、住院时间),同时比较两种术式的淋巴清除率及术后并发症发生情况。结果研究组出血量、切口长度、胃肠功能恢复时间、首次进食时间、住院时间分别为(161.34±61.54)ml、(4.67±2.03)cm、(3.03±0.84)d、(5.45±0.75)d、(10.30±1.94)d显著低于对照组的(331.30±90.24)ml、(17.05±2.31)cm、(4.64±1.51)d、(5.81±1.03)d、(12.48±3.03)d,差异均具有统计学意义(P<0.05)。对照组手术时间短于研究组,差异有统计学意义(P<0.05),两组淋巴结清除数量比较差异无统计学意义(P>0.05);研究组总发生率为13.46%,低于对照组的15.38%,但两组比较差异无统计学意义(P>0.05)。结论腹腔镜全胃D2根治术与开腹手术的淋巴数量清除效果相当,但前者手术指标及康复指标均优于开腹手术,故应将腹腔镜全胃D2根治术作为胃上部癌的首选治疗方案。
Objective To analyze the clinical effect and safety of laparoscopic radical D2 surgery and laparotomy in the treatment of upper gastric cancer. Methods One hundred and four patients with upper gastric cancer were randomly divided into study group and control group, with 52 cases in each group. The study group received D2 laparoscopic radical gastrectomy and the control group received laparotomy. The operative indexes (operative time , Bleeding volume and length of incision), rehabilitation indexes (gastrointestinal function recovery time, first feeding time and hospitalization time). The lymph node clearance rate and postoperative complications were compared between the two operations. Results The bleeding volume, incision length, gastrointestinal function recovery time, first feeding time and hospital stay in the study group were (161.34 ± 61.54) ml, (4.67 ± 2.03) cm, (3.03 ± 0.84) d, (5.45 ± 0.75) d , (10.30 ± 1.94) d were significantly lower than that of the control group (331.30 ± 90.24) ml, (17.05 ± 2.31) cm, (4.64 ± 1.51) d, (5.81 ± 1.03) d and (12.48 ± 3.03) d respectively Statistically significant (P <0.05). The operation time of the control group was shorter than that of the study group, with significant difference (P <0.05). There was no significant difference in the number of lymph node clearance between the two groups (P> 0.05). The total incidence of the study group was 13.46% Of 15.38%, but there was no significant difference between the two groups (P> 0.05). Conclusions Laparoscopic total stomach D2 radical resection has the same effect as laparotomy in lymphadenectomy. However, the former surgery index and rehabilitation index are better than laparotomy. Therefore, laparoscopic radical D2 surgery should be the first choice of upper gastric cancer Program.