CAJ | 학술논문

目的探讨腹腔镜辅助远端胃癌D2根治术的治疗效果.方法分析2008年11月至2011年10月行腹腔镜辅助和开腹远端胃癌D2根治术患者的临床资料,其中腹腔镜组61例,开腹组37例作为对照.结果 56例顺利完成腹腔镜手术,5例中转,手术时间:腹腔镜组(178.00±15.51) min,开腹组(147.86±17.41) min；术中出血量:腹腔镜组(138.43±39.67) ml,开腹组(362.86±59.86) ml(P＜0.05)；平均切口长度:腹腔镜组(5.12±0.85)cm,开腹组(18.40±1.98) cm；两组在淋巴结清扫数量上差异无统计学意义(P＞0.05).开腹组术后发生5例肺部感染,腹腔镜组发生3例肺部感染,差异无统计学意义(P＞0.05).根据术后病检回报:两组均达到了癌肿的整块切除.规律随访得知所有患者均存活,未发现有远处转移.结论腹腔镜辅助胃癌D2根治手术可以达到根治和微创的双重效果,其远期疗效有待进一步随访观察.
목적 탐토복강경보조원단위암D2근치술적치료효과.방법 분석2008년11월지2011년10월행복강경보조화개복원단위암D2근치술환자적림상자료,기중복강경조61례,개복조37례작위대조.결과 56례순리완성복강경수술,5례중전,수술시간:복강경조(178.00±15.51) min,개복조(147.86±17.41) min；술중출혈량:복강경조(138.43±39.67) ml,개복조(362.86±59.86) ml(P＜0.05)；평균절구장도:복강경조(5.12±0.85)cm,개복조(18.40±1.98) cm；량조재림파결청소수량상차이무통계학의의(P＞0.05).개복조술후발생5례폐부감염,복강경조발생3례폐부감염,차이무통계학의의(P＞0.05).근거술후병검회보:량조균체도료암종적정괴절제.규률수방득지소유환자균존활,미발현유원처전이.결론 복강경보조위암D2근치수술가이체도근치화미창적쌍중효과,기원기료효유대진일보수방관찰.
Objective To investigate the curative effectiveness of laparoscopic-assisted radical distal gastrectomy.Methods The clinical data of patients with distal gastric cancer were retrospectively analyzed in our department during November 2008 and October 2011.All patients were subjected to the laparoscopic-assisted (n =61) or open (n =37) radical distal gastrectomy with D2 lymph node dissection.Results In laparoscopic-assisted group,56 cases underwent laparoscopic-assisted surgery successfully and 5 cases were converted to open surgerys.By comparison,the operation time in laparoscopic-assisted group was longer than in open group [(178.00 ± 15.51) min vs.(147.86 ± 17.41) min].In laparoscopic-assisted group and control group,the blood loss was (138.43 ±39.67) and (362.86 ±59.86) ml,incision length was (5.12 ± 0.85) and (18.40 ± 1.98) cm,and postoperative anal exhaust time was (3.18 ±0.86) and (4.29 ± 1.09) days,respectively (P ＜0.05).There was no significant difference in the number of the lymph nodes and the postoperative pulmonary infection between two groups (P ＞ 0.05).According to the postoperative pathologic results,the radical resection was achieved in two group.During the regular follow-up period,all patients were alive and had no distant metastasis.Conclusion Laparoscopic-assisted radical gastrectomy with D2 lymphadenectomy can achieve the same cancer clearance as open surgery.It is safe,feasible and minimally invasive.