【摘要】：目的:通過(guò)對(duì)比腹腔鏡輔助胃癌D2根治術(shù)與開(kāi)腹手術(shù)的近期療效,評(píng)估腹腔鏡輔助胃癌D2根治手術(shù)在治療進(jìn)展期胃癌中的安全性、根治性及臨床應(yīng)用價(jià)值。方法:通過(guò)回顧性分析的方法,收集2014年10月至2016年11月期間在我院胃腸腫瘤外科行腹腔鏡輔助及開(kāi)腹胃癌D2根治術(shù)病人的臨床資料,按照本次研究的的納入及排除標(biāo)準(zhǔn),篩選出腹腔鏡40例、開(kāi)腹組40例。研究的相關(guān)指標(biāo)為:患者的性別、年齡、體重指數(shù)、腫瘤部位、手術(shù)切除范圍及術(shù)后分期等可能影響本研究的一般資料;兩組病人術(shù)中出血量、手術(shù)時(shí)間長(zhǎng)度、淋巴結(jié)檢出數(shù)等手術(shù)相關(guān)指標(biāo);兩組病人術(shù)后通氣時(shí)間、腹腔引流管拔出時(shí)間、術(shù)后住院日等術(shù)后恢復(fù)指標(biāo);術(shù)后并發(fā)癥發(fā)生情況。通過(guò)對(duì)上述幾組指標(biāo)進(jìn)行統(tǒng)計(jì)學(xué)分析,評(píng)估腹腔鏡輔助胃癌D2根治手術(shù)治療進(jìn)展期胃癌的近期臨床療效。結(jié)果:兩組病例在性別、年齡、BMI、腫瘤部位、手術(shù)方式、術(shù)后病理分期方面無(wú)統(tǒng)計(jì)學(xué)意義(P㧐0.05),具有可比性。腔鏡組比開(kāi)腹組術(shù)中出血少(P㩳0.05),有統(tǒng)計(jì)學(xué)差異。與開(kāi)腹組相比,腹腔鏡組術(shù)后通氣快、拔管早、術(shù)后住院日短(P㩳0.05),此三項(xiàng)指標(biāo)均有統(tǒng)計(jì)學(xué)差異。兩組在手術(shù)時(shí)間相比,腹腔鏡組手術(shù)時(shí)間明顯較開(kāi)腹組長(zhǎng)(P㩳0.05),具有統(tǒng)計(jì)學(xué)意義。兩組在淋巴結(jié)檢出數(shù)、術(shù)后并發(fā)癥方面無(wú)統(tǒng)計(jì)學(xué)差異(P㧐0.05)結(jié)論:腹腔鏡輔助胃癌D2根治術(shù)和開(kāi)腹胃癌手術(shù)相比,具有術(shù)中創(chuàng)傷小、出血少等優(yōu)點(diǎn),而且可達(dá)到與傳統(tǒng)開(kāi)腹手術(shù)相同的腫瘤根治程度。并且術(shù)后近期內(nèi)通氣快、住院日短,并發(fā)癥發(fā)生率與開(kāi)腹無(wú)異,是安全可行的。
[Abstract]:Objective: to evaluate the safety, efficacy and clinical value of laparoscopic assisted D2 radical gastrectomy for advanced gastric cancer. Methods: by retrospective analysis, the clinical data of patients undergoing laparoscopic assisted and open D2 radical gastrectomy for gastric cancer in our hospital from October 2014 to November 2016 were collected, according to the inclusion and exclusion criteria of this study. There were 40 cases of laparoscopy and 40 cases of open group. The related indexes of the study were: sex, age, body mass index, tumor location, surgical resection range and postoperative stages, etc., the amount of intraoperative bleeding, the length of operation time, and so on. The postoperative recovery indexes such as the number of lymph nodes detected, the time of postoperative ventilation, the time of pulling out the peritoneal drainage tube, the days of postoperative hospitalization, and the postoperative complications occurred in the two groups. To evaluate the short-term clinical effect of laparoscopic assisted D2 radical operation for advanced gastric cancer. Results: there was no significant difference between the two groups in sex, age, tumor location, operation mode and postoperative pathological stage (P0. 05). The operative bleeding in the endoscopic group was less than that in the laparotomy group (P < 0.05). Compared with the laparotomy group, the laparoscopic group had the advantages of quick ventilation, early extubation and short hospital stay (P0. 05). The operative time in the laparoscopy group was significantly longer than that in the open group (P0. 05). There was no significant difference in lymph node detection and postoperative complications between the two groups (P0. 05) conclusion: laparoscopic assisted D2 radical gastrectomy has the advantages of less trauma and less bleeding. And it can reach the same degree of radical resection as traditional open surgery. It is safe and feasible that the postoperative ventilation is quick, the hospital stay is short, the complication rate is the same as the open operation.
【學(xué)位授予單位】：青海大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R735.2

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