本文選題：胃癌 + 進(jìn)展期��； 參考：《中國(guó)微創(chuàng)外科雜志》2017年07期

【摘要】：目的探討腹腔鏡輔助全胃D2根治術(shù)治療進(jìn)展期胃癌的應(yīng)用價(jià)值。方法回顧性分析我科2012年2月~2015年7月83例進(jìn)展期胃癌行全胃D2根治術(shù)的臨床資料,其中腹腔鏡輔助胃癌根治術(shù)40例(腔鏡組),開(kāi)腹胃癌根治術(shù)43例(開(kāi)腹組)。比較2組圍術(shù)期情況、術(shù)后病理和術(shù)后生存情況。結(jié)果腔鏡組3例(7.5%)中轉(zhuǎn)開(kāi)腹。腔鏡組手術(shù)時(shí)間明顯長(zhǎng)于開(kāi)腹組[(266.0±36.3)min vs.(226.0±28.5)min,t=5.602,P=0.000],術(shù)中出血量明顯少于開(kāi)腹組[(156.2±55.7)ml vs.(261.6±87.2)ml,t=-6.609,P=0.000],術(shù)后腸功能恢復(fù)時(shí)間[(3.1±1.1)d vs.(3.7±1.5)d,t=-2.070,P=0.042]和住院時(shí)間[(14.5±3.9)d vs.(16.0±2.6)d,t=-2.135,P=0.036]明顯短于開(kāi)腹組。2組術(shù)中輸血率差異無(wú)顯著性[60.0%(24/40)vs.65.1%(28/43),χ~2=0.232,P=0.630]。2組術(shù)后并發(fā)癥發(fā)生率差異無(wú)顯著性[35.0%(14/40)vs.44.2%(19/43),χ~2=0.730,P=0.393]。2組所有病例均為R0切除,淋巴結(jié)清掃數(shù)目[(24.9±6.0)枚vs.(26.3±5.1)枚,t=-1.163,P=0.248]、淋巴結(jié)轉(zhuǎn)移率[85.0%(34/40)vs.86.0%(37/43),χ~2=0.018,P=0.892]、陽(yáng)性淋巴結(jié)數(shù)目[(5.8±3.7)枚vs.(6.2±3.1)枚,t=-0.452,P=0.653]、腫瘤TNM分期(χ~2=0.673,P=0.714)均無(wú)顯著性差異。2組生存率無(wú)顯著性差異(log-rank檢驗(yàn),χ~2=0.774,P=0.379)。結(jié)論與傳統(tǒng)開(kāi)腹手術(shù)相比,腹腔鏡輔助全胃D2根治術(shù)治療進(jìn)展期胃癌安全可行,手術(shù)創(chuàng)傷小、術(shù)后恢復(fù)快,且胃周淋巴結(jié)清掃效果同開(kāi)腹手術(shù)一致,術(shù)后總體生存率不低于開(kāi)腹手術(shù)。
[Abstract]:Objective to evaluate the value of laparoscopic assisted D 2 radical gastrectomy in the treatment of advanced gastric cancer. Methods the clinical data of 83 patients with advanced gastric cancer undergoing total gastric D2 radical gastrectomy from February 2012 to July 2015 were retrospectively analyzed, including 40 cases of laparoscopic assisted radical gastrectomy (endoscopic group) and 43 cases of open radical gastrectomy (open group). The perioperative period, postoperative pathology and postoperative survival were compared between the two groups. Results 3 cases (7.5%) in the endoscopic group were converted to open operation. 鑵旈暅緇勬墜鏈椂闂存槑鏄鵑暱浜庡紑鑵圭粍[(266.0鹵36.3)min vs.(226.0鹵28.5)min,t=5.602,P=0.000],鏈腑鍑?guó)櫋�閲忔槑鏄懼皯浜庡紑鑵圭粍[(156.2鹵55.7)ml vs.(261.6鹵87.2)ml,t=-6.609,P=0.000],鏈悗鑲犲姛鑳芥仮澶嶆椂闂碵(3.1鹵1.1)d vs.(3.7鹵1.5)d,t=-2.070,P=0.042]鍜屼綇闄㈡椂闂碵(14.5鹵3.9)d vs.(16.0鹵2.6)d,t=-2.135,P=0.036]鏄庢樉鐭簬寮，

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