CAJ | 학술논문

目的：比较开腹和腹腔镜D2淋巴结清扫术式用于进展期胃癌患者的临床疗效。方法研究对象选取近年来收治的进展期胃癌患者共90例，采用随机数字表法分为A组（45例）和B组（45例），分别采用开腹和腹腔镜D2淋巴结清扫术式治疗；比较两组患者围手术期临床指标、淋巴结清扫数目，随访1年生存率及术后并发症发生率等。结果 B组围手术期临床指标均显著优于A组，差异均有统计学意义（t＝2.13、2．56、1．98、1．96、1．94、2．05、2．10，均P＜0．05）；B组第二站淋巴结清扫数目显著少于A组，差异有统计学意义（t＝2．15，P＜0．05）；A组和B组随访1年生存率分别为88．89％、91．11％，两组1年生存率比较差异无统计学意义（χ2＝1．67，P＞0．05）；A组和B组术后并发症发生率分别为20．00％、8．89％，B组术后并发症发生率显著低于A组，差异有统计学意义（χ2＝9．44，P＜0．05）。结论腹腔镜D2淋巴结清扫术式用于进展期胃癌患者可有效减少术中创伤，加快术后康复进程，并有助于降低术后并发症发生风险，效果优于开腹D2淋巴结清扫术式。
목적：비교개복화복강경D2림파결청소술식용우진전기위암환자적림상료효。방법연구대상선취근년래수치적진전기위암환자공90례，채용수궤수자표법분위A조（45례）화B조（45례），분별채용개복화복강경D2림파결청소술식치료；비교량조환자위수술기림상지표、림파결청소수목，수방1년생존솔급술후병발증발생솔등。결과 B조위수술기림상지표균현저우우A조，차이균유통계학의의（t＝2.13、2．56、1．98、1．96、1．94、2．05、2．10，균P＜0．05）；B조제이참림파결청소수목현저소우A조，차이유통계학의의（t＝2．15，P＜0．05）；A조화B조수방1년생존솔분별위88．89％、91．11％，량조1년생존솔비교차이무통계학의의（χ2＝1．67，P＞0．05）；A조화B조술후병발증발생솔분별위20．00％、8．89％，B조술후병발증발생솔현저저우A조，차이유통계학의의（χ2＝9．44，P＜0．05）。결론복강경D2림파결청소술식용우진전기위암환자가유효감소술중창상，가쾌술후강복진정，병유조우강저술후병발증발생풍험，효과우우개복D2림파결청소술식。
Objective To investigate the clinical effects differences of two kinds of D2 lymphadenectomy in the treatment of patients with advanced gastric cancer including open operation and laparoscopy operation.Methods 90 patients with advanced gastric cancer were chosen in recent years in our hospital and were randomly divided into both group including group A (45 patients)with D2 lymphadenectomy by open operation and group B (45 patients) with D2 lymphadenectomy by laparoscopy operation;and the clinical indicators in peri-operation period,the dissec-tion number of lymph node,survival rate in 1 year with follow-up and postoperative complication incidence of both groups were compared.Results The clinical indicators in peri-operation period of group B was significantly better than that of group A (t=2.13,2.56,1.98,1.96,1.94,2.05,2.10,all P<0.05).The N2 dissection number of lymph node of group B was significantly fewer than that of group A (t=2.15,P<0.05).The survival rate in 1 year with follow-up of group A and group B were separately 88.89%and 91.11%,there was no significant difference in survival rate in 1 year with follow-up between the two groups(χ2 =1.67,P>0.05).The postoperative complication incidence of group A and group B were separately 20.00% and 8.89%,the postoperative complication incidence of group B was significantly lower than that of group A (χ2 =9.44,P<0.05).Conclusion Compared with D2 lymph-adenectomy by open operation,D2 lymphadenectomy by laparoscopy operation in treatment of patients with advanced gastric cancer can efficiently decrease the degree of surgical trauma,accelerate the process of recovering after opera-tion,and be helpful to reduce the risk of postoperative complications.