CAJ | 학술논문

目的：比较腹腔镜辅助远端胃癌D2根治术与开腹远端胃癌D2根治术疗效、安全性及应用价值。方法回顾性分析2010年7月～2011年10月在我院行远端胃癌根治术80例患者资料，其中腹腔镜辅助远端胃癌根治手术35例（腹腔镜组），与同期开腹远端胃癌根治手术45例（开腹组）对比分析腹腔镜组与开腹组病人术中和术后情况、并发症及近期生存差异。结果腹腔镜组与开腹组一般资料、肿瘤位置、病理学分化类型、转移淋巴结数目、清扫淋巴结数目、肿瘤浸润深度、肿瘤TNM分期、术中出血、术后并发症、近期生存率差异无统计学意义（P＞0.05），腹腔镜组手术时间长于开腹组（P＜0.05），腹腔镜组切口长度、术后下床活动、术后排气时间、术后进食时间、术后住院时间均少于开腹组，差异有统计学意义（ P＜0.05）。结论腹腔镜辅助胃癌D2根治手术是安全可行的，能达到开腹手术同样的根治效果，具有创伤小、术后恢复快等优势。
목적：비교복강경보조원단위암D2근치술여개복원단위암D2근치술료효、안전성급응용개치。방법회고성분석2010년7월～2011년10월재아원행원단위암근치술80례환자자료，기중복강경보조원단위암근치수술35례（복강경조），여동기개복원단위암근치수술45례（개복조）대비분석복강경조여개복조병인술중화술후정황、병발증급근기생존차이。결과복강경조여개복조일반자료、종류위치、병이학분화류형、전이림파결수목、청소림파결수목、종류침윤심도、종류TNM분기、술중출혈、술후병발증、근기생존솔차이무통계학의의（P＞0.05），복강경조수술시간장우개복조（P＜0.05），복강경조절구장도、술후하상활동、술후배기시간、술후진식시간、술후주원시간균소우개복조，차이유통계학의의（ P＜0.05）。결론복강경보조위암D2근치수술시안전가행적，능체도개복수술동양적근치효과，구유창상소、술후회복쾌등우세。
Objective To evaluate the safety and value of laparoscopic radical resection of dis-tal gastric cancer with D2 lymph node dissection and compare its efficacy with open radical sur-gery.Methods Clinical data of 80 patients with distal gastric cancer underwent radical gas-trectomy in our hospital from July 2010 to October 2011 were retrospectively analyzed .Among the patients, 35 cases were given laparoscopic assisted radical distal gastrectomy ( laparoscopic group ) and 45 cases were given open distal gastrectomy ( open surgery group ) in the same peri-od.The differences of intraoperative and postoperative situation ,postoperative complications and short-term survival rates between laparoscopy and open surgery group were analyzed .Results Laparoscopic surgery group with open surgery group had no statistically significant differences in gender , age , tumor location , tumor diameter , grade of differentitation , number of lymph node metastasis,number of lymph nodes dissection , depth of tumor invasion , TNM staging, blood loss, postoperative complications and short-term survival rate.The operative time of the laparo-scopic group was significantly longer than that of the open group ( P<0.05 ) , the length of inci-sion, postoperative ambulation time , postoperative exhaust time , postoperative eating time , hospital stay were shorter after open surgery group , which showed statistically significant differ-ences compared with open surgery group ( P<0.05 ) .Conclusion Laparoscopic radical gas-trectomy is safe , procedure and matches the results of open surgery , but postoperative recovery fast and less invasive .