CAJ | 학술논문

目的：分析腹腔镜对比传统开腹手术行胃肿瘤D2根治术的疗效。方法：回顾性分析兰州市第二人民医院肿瘤外科2012年2月2012年12月期间完成开腹手术行胃肿瘤D2根治术（开腹手术组，36例）和腹腔镜胃肿瘤D2根治术（腹腔镜组，35例）患者的临床资料，分析2组患者的手术切口长度，手术时间，手术期间出血量，手术后住院时间、伤口感染和肠梗阻的发生率、手术后止痛药应用次数、排气时间、进流食时间、平均淋巴结清扫数目等。采用SPSS19.0统计软件进行统计分析。结果：腹腔镜组和开腹手术组在手术切口长度、手术时间、手术后止痛药应用情况、排气时间、术后伤口感染发生率和肠梗阻的并发症发生率方面的差异有统计学意义（P<0.05），但在术中出血量、术后住院时间、进流食时间、平均淋巴结清扫数目等方面的差异无统计学意义（P>0.05）。结论：腹腔镜胃肿瘤D2根治术是安全可行的，能达到与开腹手术相同的淋巴结清扫范围，且具有对患者创伤小、手术中出血少、手术后恢复快等优点，在临床值得应用和推广。但远期效果还需要进一步研究。
목적：분석복강경대비전통개복수술행위종류D2근치술적료효。방법：회고성분석란주시제이인민의원종류외과2012년2월2012년12월기간완성개복수술행위종류D2근치술（개복수술조，36례）화복강경위종류D2근치술（복강경조，35례）환자적림상자료，분석2조환자적수술절구장도，수술시간，수술기간출혈량，수술후주원시간、상구감염화장경조적발생솔、수술후지통약응용차수、배기시간、진류식시간、평균림파결청소수목등。채용SPSS19.0통계연건진행통계분석。결과：복강경조화개복수술조재수술절구장도、수술시간、수술후지통약응용정황、배기시간、술후상구감염발생솔화장경조적병발증발생솔방면적차이유통계학의의（P<0.05），단재술중출혈량、술후주원시간、진류식시간、평균림파결청소수목등방면적차이무통계학의의（P>0.05）。결론：복강경위종류D2근치술시안전가행적，능체도여개복수술상동적림파결청소범위，차구유대환자창상소、수술중출혈소、수술후회복쾌등우점，재림상치득응용화추엄。단원기효과환수요진일보연구。
Objective:To evaluate the effectiveness of laparoscopy versus open surgery with D2 lymphadenectomy for gastric cancer. Methods: From Jan 2012 to Jan 2013, a series of 36 patients were undertook open distal gastrectomy D2 gastrectomy (open group), 35 patients were undertook laparoscopic assisted D2 gastrectomy (laparoscopic group) in which the related outcome of two groups were compared including length of incision,surgical duration,intraoperative blood loss,the number of wound infection and intestinal obstruction,the situation of postoperative pain,exhaust time,postoperative eating date,numbers of harvested lymph nodes. The data were analyzed by SPSS19.0 software in two groups. Results: There were significant difference between two groups in length of incision,surgical duration,the situation of postoperative pain,exhaust time,and the number of wound infection and intestinal obstruction,but no difference in intraoperative blood loss,hospital stay,postoperative eating date, time of drainage and cost of operation, but no difference in surgical duration,intraoperative blood loss,and numbers of harvested lymph nodes. Conclusion: Laparoscopical D2 lymphadenectomy for gastric cancer is a safe,feasible,effective and minimally invasive technique with short term outcome,but the long term effect of laparoscopy still needs further confirmation.