腹腔镜与开腹进展期远端胃癌d2根治术的远期疗效分析外科学普外专业论文.docxVIP

第三军医大学硕士学位论文Retrospective 第三军医大学硕士学位论文 Retrospective study comparing long--term outcomes between Laparoscopic and open distal gastrectomy with D2 lymph dissection for advanced gastric cancer Abstract Background Gastric cancer is one of the most frequently occurring cancer and the incidences are highly in east Asian countries such as China，Japan and Korea according to the World Health Organization．The number of new cases has climbed to more than four hundred thousands per year and over three hundred thousands died due to gastric cancer．Because of serious imbalance of distribution in medical resources of china，it is difficult to carry out to screening high—risk group．Meanwhile，there is no special sign and symptom in patients at an early stage．The number of patients with early gastric cancer(EGC)would account for less than 1 0 percent of the hospitalized patients．The majority of patients are diagnosed with advanced stage which reveals poor prognosis because of the metastasis of lymph node， blood and peritoneal．For now,radical surgery is still a hoping curative method for gastric cancer．The radical gastrectomy for gastric cancer has been achieved progressively in recent two decades，not just in the improvement of the radical resection and survival rate，it also displays by the rapid development of minimally invasive surgery that represented by Da Vinci surgical robotic system and gastrectomy surgery．Minimally invasive surgery has become one of the main direction of modern surgery．Since the first describe of laparoscopic distal gastrectomy for early gastric cancer by professor Kitano，it has gradually accepted by the surgeon because of the advantages of less surgery trauma，rapid postoperative recovery，low incidence rate of postoperative complications and short hospital stay．1aparoscopic gastrectomy is the standard therapy for patients at stage IA as described in Japan stomach cancer treatment guideline 2002．Goh et al were the first to report the use o