腹腔镜下胃癌D2淋巴结清扫的临床疗效及中期随访报告.docxVIP

腹腔镜下胃癌D2淋巴结清扫的临床疗 效及中期随访报告 余铭薛迪新施正超陈澄亮贺新伟陈积贤马小 浙江省瑞安市人民医院肿瘤外科浙江医院消化科 摘要： 目的比较腹腔镜胃癌D2根治术与开腹手术的疗效，探讨腹腔镜胃癌D2根治术 的可行性。方法 选取浙江省瑞安市人民医院2008年10月-2013年8月收治的 胃癌患者，根据患者采取的手术方式不同分为两组，其中175例腹腔镜手术患 者纳入腹腔镜组，163例开腹手术患者纳入开腹组。比较两组患者的术屮及术后 情况、淋巴结清扫数目、并发症及肿瘤根治程度等。结果腹腔镜组清扫淋巴结 (26.3±13.9)枚，开腹组清扫淋巴结(26.8±10. 2)枚，差异无统计学意义 (t-0. 40, P二0.684) o腹腔镜组术中出血情况以及术后排气时间均优于开腹组。 腹腔镜组患者术后住院吋间小于开腹组，组间比较差异有统计学意义 (P0. 05)。腹腔镜组的3年生存率为92. 00%,与开腹组92. 63%相比较，差异无 统计学意义(x2=l?54, P=0. 262)。结论腹腔镜胃癌D2根治术具有安全、术 后恢复快和创伤小等优点，同时能够达到与开腹组相近的淋巴结清扫效果。 关键词： 腹腔镜;D2淋巴结清扫;胃癌;胃癌根治术; 作者简介：施正超，E-mail:ymszc@126. com 收稿日期:2017-03-02 Medium-term foilow~up of laparoscopic surgery on radical gastreetomy with D2 dissection for gastrie cancer Ming Yu Di-xin Xue Zheng-chao Shi Cheng-liang Chen Xin-wei He Ji-xian Chen Xiao-hong Ma Department of Surgical Oncology, Rui an Peoples Hospital; Department of Gastroenterology, Zhejiang Hospital; Abstract： Objective To explore the feasibility and clinical outcome of laparoscopy-assisted gastrectomy with D2 dissection by comparing the efficacy of open surgery on radical gastrectomy with D2 dissection for gastric camcer patients. Methods The patients with gastrie cancer from October 2008 to August 2013 were divided into two groups according to the different surgical methods. Among them, 175 patients underwent laparoscopic surgery (laparoscopy-ass is ted surgery group, Group L) , and 163 patients underwent laparotomy surgery (open surgery group, Group 0). The number of lymph nodes dissected, postopcrativc recovery, complications, mortality and survival rate of the two groups were compared and analyzed. Results There was no significant difference in the number of lymph nodes resect between the two groups [Group L and Group 0: (26. 3 土 13.9) vs (26. 8 土 10.2) , t 二-0. 40, P 二 0. 684]. Compared wi th open surgery, the laparoscopy-assisted surgery showed signifiedntly less intraoperative blood loss and quicker recovery of gastrointestinal function. The postoperative hospitalization time of laparoscop