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目的随访观察并探讨微创根治手术治疗胃癌的近远期疗效。方法 98例胃癌患者,其中49例患者行微创根治术(腹腔镜辅助远端胃癌根治术),设为微创组;另外49例患者行常规开腹手术,设为开腹组。比较两组术后的各项临床指标(术中出血量、手术时间、进食流质时间、排气时间、住院时间、淋巴结清扫数目)、术后并发症发生率以及患者存在的危险因素。结果手术后,微创组除淋巴结清扫数目及手术时间外其他临床指标均明显优于开腹组,差异均具有统计学意义(P<0.05);并且微创组并发症发生率为16.75%,低于开腹组的32.55%,差异具有统计学意义(P<0.05)。且由实验可知,腹腔镜辅助胃癌根治手术的危险因素为术前合并症及手术时间。微创组5年存活率与开腹组相比差异无统计学意义(P>0.05)。结论微创根治术治疗进展期胃癌的近期疗效优于常规开腹手术,而远期疗效两者相比无差异,所以在临床上进行微创根治术治疗有重大意义。
Objective To investigate the short-term and long-term curative effects of minimally invasive radical operation on gastric cancer. Methods Ninety-nine patients with gastric cancer, of whom 49 patients underwent minimally invasive radical mastectomy (laparoscopic-assisted radical gastrectomy for distal gastric cancer), were set as the minimally invasive group. Another 49 patients underwent conventional laparotomy as an open group. All the clinical indexes (intraoperative blood loss, operation time, food intake time, exhaust time, hospitalization time, number of lymph node dissection), postoperative complications and risk factors were compared between the two groups. Results In the minimally invasive group, except for the number of lymph nodes dissection and operation time, other clinical indexes were significantly better than those of the open group (P <0.05). The incidence of complications in the minimally invasive group was 16.75% Lower than 32.55% in open group, the difference was statistically significant (P <0.05). And from the experiment shows that laparoscopic-assisted radical surgery of gastric cancer risk factors for preoperative complications and operation time. The 5-year survival rate in minimally invasive group was not significantly different from that in open group (P> 0.05). Conclusion Minimally invasive radical mastectomy is superior to conventional laparotomy in the treatment of advanced gastric cancer. However, there is no difference in the long-term curative effect between the two groups. Therefore, minimally invasive radical mastectomy is of clinical significance.