现代医药卫生
現代醫藥衛生
현대의약위생
MODERN MEDICINE HEALTH
2014年
23期
3521-3524,3529
,共5页
腹腔镜检查%胃肿瘤/外科学%胃切除术%淋巴结切除术%随访研究%进展期胃癌
腹腔鏡檢查%胃腫瘤/外科學%胃切除術%淋巴結切除術%隨訪研究%進展期胃癌
복강경검사%위종류/외과학%위절제술%림파결절제술%수방연구%진전기위암
Laparoscopy%Stomach neoplasms/surgery%Gastrectomy%Lymph node excision%Follow-up study%Advanced gastrics cancer
目的：比较腹腔镜下胃癌D2根治术（LAG-D2）与传统开腹胃癌D2根治术（OG）治疗进展期胃癌患者的临床效果，并评估腹腔镜下手术安全性。方法选择2008年10月至2009年2月术前临床分期为T2、T3或T4的进展期胃癌患者67例，其中LAG-D2组37例，OG组30例。两组患者均严格按照胃癌D2根治术进行，完全清扫第2组淋巴结。观察比较两组患者一般资料、术中情况、术后结果、病理特征，并严格随访两组患者术后的长期疗效。结果 LAG-D2组患者较OG组术中出血更少，术后住院时间明显缩短，但手术时间更长，差异均有统计学意义（P<0.01）。两组患者肺部及切口感染手术并发症发生率比较，差异有统计学意义（P＜0.01）。两组围术期均无死亡病例。LAG-D2组患者复发率[29.7％（11/37）]与OG组[30.0％（9/30）]比较，差异无统计学意义（P>0.05）。LAG-D2组患者5年无瘤生存率和总生存率分别为64.7%（22/34）和67.6％（23/34），OG 组为64.3％（18/28）和67.9％（19/28），两组比较，差异均无统计学意义（P>0.05）。结论LAG-D2与OG对于进展期胃癌治疗其根治性效果相似，具有手术切口小、出血少、恢复快、并发症少、安全可靠等优点。LAG-D2可以替代传统OG治疗进展期胃癌。
目的：比較腹腔鏡下胃癌D2根治術（LAG-D2）與傳統開腹胃癌D2根治術（OG）治療進展期胃癌患者的臨床效果，併評估腹腔鏡下手術安全性。方法選擇2008年10月至2009年2月術前臨床分期為T2、T3或T4的進展期胃癌患者67例，其中LAG-D2組37例，OG組30例。兩組患者均嚴格按照胃癌D2根治術進行，完全清掃第2組淋巴結。觀察比較兩組患者一般資料、術中情況、術後結果、病理特徵，併嚴格隨訪兩組患者術後的長期療效。結果 LAG-D2組患者較OG組術中齣血更少，術後住院時間明顯縮短，但手術時間更長，差異均有統計學意義（P<0.01）。兩組患者肺部及切口感染手術併髮癥髮生率比較，差異有統計學意義（P＜0.01）。兩組圍術期均無死亡病例。LAG-D2組患者複髮率[29.7％（11/37）]與OG組[30.0％（9/30）]比較，差異無統計學意義（P>0.05）。LAG-D2組患者5年無瘤生存率和總生存率分彆為64.7%（22/34）和67.6％（23/34），OG 組為64.3％（18/28）和67.9％（19/28），兩組比較，差異均無統計學意義（P>0.05）。結論LAG-D2與OG對于進展期胃癌治療其根治性效果相似，具有手術切口小、齣血少、恢複快、併髮癥少、安全可靠等優點。LAG-D2可以替代傳統OG治療進展期胃癌。
목적：비교복강경하위암D2근치술（LAG-D2）여전통개복위암D2근치술（OG）치료진전기위암환자적림상효과，병평고복강경하수술안전성。방법선택2008년10월지2009년2월술전림상분기위T2、T3혹T4적진전기위암환자67례，기중LAG-D2조37례，OG조30례。량조환자균엄격안조위암D2근치술진행，완전청소제2조림파결。관찰비교량조환자일반자료、술중정황、술후결과、병리특정，병엄격수방량조환자술후적장기료효。결과 LAG-D2조환자교OG조술중출혈경소，술후주원시간명현축단，단수술시간경장，차이균유통계학의의（P<0.01）。량조환자폐부급절구감염수술병발증발생솔비교，차이유통계학의의（P＜0.01）。량조위술기균무사망병례。LAG-D2조환자복발솔[29.7％（11/37）]여OG조[30.0％（9/30）]비교，차이무통계학의의（P>0.05）。LAG-D2조환자5년무류생존솔화총생존솔분별위64.7%（22/34）화67.6％（23/34），OG 조위64.3％（18/28）화67.9％（19/28），량조비교，차이균무통계학의의（P>0.05）。결론LAG-D2여OG대우진전기위암치료기근치성효과상사，구유수술절구소、출혈소、회복쾌、병발증소、안전가고등우점。LAG-D2가이체대전통OG치료진전기위암。
Objective To compare the treatment effect of laparoscopic D2 gastrectomy (LAG-D2) and open D2 gastrec tomy(OG) in the treatment of patients with advanced gastric cancer,and evaluate the safety of LAG-D2. Methods A total of 67 pa-tients with advanced gastric cancer staging T2,T3,or T4 clinically,were selected from October 2008 and February 2009,including 37 cases in LAG-D2 group and 30 cases in OG group. Both groups were treated with gastric carncer OG ,and resected the lymph nodes in the second station thoroughly. To compare and analyze the general information ,intraoperative condition,postoperative re-sults and pathological features of the patients in the both groups ,and the long-term efficacy was followed up seriously. Results Compared with the OG group,the amount of bleeding was less,postoperative length of stay was shorter but the length of operation was longer in the LAG-D2 group,and the differences between the two groups had statistical significance (P<0.01). The difference be-tween the two groups in incidences of pulmonary infection and incision infection was statistically significant (P<0.01). No death occurred in the both groups in perioperative period. The recurrence rate between the LAG-D2 group [29.7%(11/37)] and the OG group[30.0%(9/30)] had no statistically significant difference(P>0.05). The five-year disease free survival rate and overall survival rate were 64.7%(22/34) and 67.6%(23/34) respectively in the LAG-D2 group,compared with the OG group [64.3%(18/28), 67.9%(19/28)],the differences had no statistical significance (P>0.05). Conclusion In the LAG-D2 and OG groups,it has the similar curative effect in the treatment of advanced gastric cancer and advantages of small incision ,less amount of bleeding,rapid recovery,fewer complications,safe and reliable. So LAG-D2 can replace the traditional OG for advanced gastric cancer.
