CAJ | 학술논문

目的：观察腹腔镜辅助手术与开腹手术治疗胃癌的近期疗效与安全性。方法回顾分析解放军白求恩国际和平医院2009年6月—2013年6月收治的300例胃癌患者的临床资料，按手术方式分为腹腔镜手术组(148例)与开腹手术组(152例)，均按胃癌D2根治术标准行手术治疗，分析两组手术相关指标、临床病理特征、并发症发生及近期随访情况。结果与开腹手术组比较，腹腔镜手术组切口长度短、术中出血量少、术后排便时间和住院时间短(P<0．05)；两组肿瘤大小、部位、病理分期、分化程度、并发症发生率差异均无统计学意义(P>0．05)；随访6~48个月，平均24个月，两组肿瘤复发率、转移率及病死率差异均无统计学意义( P>0．05)。结论腹腔镜手术与开腹手术治疗胃癌临床效果及安全性相当，但腹腔镜手术创伤更小，术后恢复更快，值得临床推广。
목적：관찰복강경보조수술여개복수술치료위암적근기료효여안전성。방법회고분석해방군백구은국제화평의원2009년6월—2013년6월수치적300례위암환자적림상자료，안수술방식분위복강경수술조(148례)여개복수술조(152례)，균안위암D2근치술표준행수술치료，분석량조수술상관지표、림상병리특정、병발증발생급근기수방정황。결과여개복수술조비교，복강경수술조절구장도단、술중출혈량소、술후배편시간화주원시간단(P<0．05)；량조종류대소、부위、병리분기、분화정도、병발증발생솔차이균무통계학의의(P>0．05)；수방6~48개월，평균24개월，량조종류복발솔、전이솔급병사솔차이균무통계학의의( P>0．05)。결론복강경수술여개복수술치료위암림상효과급안전성상당，단복강경수술창상경소，술후회복경쾌，치득림상추엄。
Objective To observe the near-term effect and safety between laparoscopic gastric radical surgery and open gastrectomy in treatment of gastric cancer. Methods Clinical data of 300 patients with gastric cancer during July 2009 and July 2013 undergoing D2 radical surgery at the same period was retrospectively analyzed, and the patients were divided into laparoscopic gastric radical surgery (group A, n=148) and open gastrectomy (group B, n=152) ac-cording to operative methods. The related indexes of surgery, clinicopathological characteristics, incidence rate of postop-erative complications and the condition of recent follow-up were compared and analyzed. Results Compared with those in group B, the values of length of incision, volume of blood loss, postoperative beginning defecation time and hospital stay in group A were significantly lower (P<0. 05), while the differences in tumor diameter, positions, TNM staging, differentiation levels and incidence rate of postoperative complications were not statistically significant ( P>0. 05 ); the follow-up period of the two groups was 6-48 months, and the average time was 24 months;the differences in recurrence, metastasis and fatality rates were not statistically significant ( P>0. 05 ) . Conclusion Laparoscopic gastric D2 radical surgery and the open gastrectomy have the similar near-term effect and safety in treatment of gastric cancer, while the lap-aroscopic gastric D2 radical surgery is less invasive with better postoperative recovery.